Voice Work: Art and Science in Changing Voices

Voice Work

Voice Work: Art and Science in Changing Voices. Christina Shewell © 2009 Christina Shewell. ISBN: 978-0-470-01992-4

To Mark and to Jack, and to my dear first family, Harry, Hilary and Susie, with love

Voice Work Art and Science in Changing Voices Christina Shewell ma, cert mrcslt, advs Voice teacher and speech and language therapist

A John Wiley & Sons, Ltd., Publication

This edition first published 2009 © 2009 Christina Shewell Wiley-Blackwell is an imprint of John Wiley & Sons, formed by the merger of Wiley’s global Scientific, Technical and Medical business with Blackwell Publishing. Registered office John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, United Kingdom Editorial office John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, United Kingdom For details of our global editorial offices, for customer services and for information about how to apply for permission to reuse the copyright material in this book please see our website at www. wiley.com/wiley-blackwell. The right of the author to be identified as the author of this work has been asserted in accordance with the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher. Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books. Designations used by companies to distinguish their products are often claimed as trademarks. All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book. This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold on the understanding that the publisher is not engaged in rendering professional services. If professional advice or other expert assistance is required, the services of a competent professional should be sought. Library of Congress Cataloging-in-Publication Data Shewell, Christina. Voice work : art and science in changing voices / Christina Shewell. p. cm. Includes bibliographical references and index. ISBN 978-0-470-01992-4 (paper) 1. Voice culture. 2. Voice. I. Title. PN4162.S48 2009 808.5–dc22 2008019022 A catalogue record for this book is available from the British Library. Set in 10 on 12 pt Sabon by SNP Best-set Typesetter Ltd., Hong Kong Printed in Singapore by Fabulous Printers Pte Ltd 1 2009

Contents

Forewords . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dawn French (professional voice user). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Lesley Mathieson (speech and language therapist) . . . . . . . . . . . . . . . . . . . . . . . . Mark Meylan (singing teacher) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Patsy Rodenburg (voice teacher) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . About the book . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Part 1

Part 2

Part 3

Part 4

vii vii viii ix x xi xiii xv

Considering voice work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1

1 The voice work continuum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 The nature of practical voice work . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3 19

Investigating voices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

33

3 Seeing voices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Hearing voices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35 51

The Voice Skills approach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

69

5 Voice skills . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 The Voice Skills Perceptual Profile . . . . . . . . . . . . . . . . . . . . . . . . . . . .

71 82

Voice work foundations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

103

7 Bodywork foundations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Breath work foundations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

105 122

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Contents

9 10 11 12 13 14 15

Channel work foundations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Phonation work foundations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Resonance work foundations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pitch work foundations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Loudness work foundations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Articulation work foundations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Voices and emotions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

144 160 175 184 195 203 216

Practical voice work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

237

16 17 18 19 20 21 22 23 24 25 26

Practical voice care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . General bodywork . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Body voice exercises . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Breath voice exercises . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Channel voice exercises. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Phonation voice exercises . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Resonance voice exercises . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pitch voice exercises . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Loudness voice exercises . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Articulation voice exercises . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Group voice exercises . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

239 258 271 293 310 335 346 356 367 377 393

Voice disturbance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

413

27 28 29 30

disordered voice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . daily working voice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . acting voice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . singing voice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

415 443 461 479

Afterword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Appendix I Organisations and websites . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

498 499 512 515

Part 5

Part 6

The The The The

Forewords

Dawn French, Comedian When I was an undergraduate of English, speech and drama, we had extensive voice training with an excellent teacher, but, as young students, the voice exercises just seemed silly. Jennifer and I would make each other laugh as a way to release the embarrassment of all those funny sounds. When we left, some of our friends actually worked as voice teachers. I didn’t, as I really had no confidence that I knew the difference between a uvula, a vulva and a Volvo. . . . As an actor I now realise that voice is one of the greatest tools and we cannot take it for granted. It’s the vehicle that connects the script and the audience; your mind operates your mouth and throat and the words come physically through you. It’s a real art to keep your own voice finely tuned between your own personality and the character you are playing. There has to be good control of the ‘natural’ breath, tone and phrasing in order to alter it for a character. It’s like clowning – you have to be good enough at the rules of physical fun to be able to twist them for clowning. Last year I did an opera and was fascinated to see how the singers held back in rehearsals, but at the dress rehearsal their full sound blew the top of my head off. That last rehearsal week and the start of a show are dangerous times for most actors as they are tired, stressed and nervous, with all the fear of the opening night and the resulting judgements. I have never once done a play where warm-ups happen in that time; everyone is far too stressed and nervous to protect their voices and yet that’s exactly when they should be doing so. There is a tricky line between relaxation and necessary tension, and it can be hard to find. Performers have to find exactly the right energy balance at any time of day and sustain that for hours. I still have a tendency to push. It’s a long-standing habit of assuming that, if I do a ‘bigger’ version of what I do in normal life, I will get away with it on stage. Like many actors, I have had to learn to do something different with my voice on stage. You cannot give a good performance if your voice is not serving you well, and it’s cripplingly awful when it fails you. I know the techniques and have mostly managed to get by, but have still had problems with my voice. On one occasion I was in the long run of a play and had developed an

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increasingly hoarse and raspy voice, but still kept pushing as I felt furious and guilty at its failure. Finally I lost it completely half-way through a show, and the understudy had to go on. I went to see a laryngologist where I was fascinated to see my vocal folds moving on a screen, and the vocal nodules that had developed. The specialist explained that I would probably always have voice problems unless I changed my pattern of voice strain and inadequate breath, and he sent me to see Christina. At that point my barriers were up and I still suspected that voice work was indulgent. It can also feel like a personal investigation of one’s whole nature – as if the voice itself has a personality – so it’s very intimate to have someone comment on it and work to change it. However, although I had thought that the voice therapy was going to be quite clinical, I actually found it surprisingly healing on both spiritual and physical levels. As Christina and I worked together, I remembered how as a child I instinctively breathed and voiced ‘well’, and realised that somewhere I did viscerally know this. Now I recognise that being furious with my voice doesn’t help; I need to nurture it, take time to breathe and use the techniques I have learnt. This book will provide me with a reminder of some of those techniques, and I genuinely believe it will sustain me through plenty of bum-twitchingly scary times. I don’t think of it as manual, I think of it more as a companion with practical knowledge and helpful insights. Who would have thought a book about voice would contain so much heart?

Lesley Mathieson FRCSLT, Speech and Language Therapist (Visiting Lecturer in Voice Pathology, The Ear Institute, University College London; Honorary Research Adviser, Department of Speech and Language Therapy, The Royal National Throat Nose and Ear Hospital, London.) Voice practitioners, whether artistic or clinical, who pick up this book and start to glance through its pages, will know immediately that it contains an enormous amount of information that will be relevant to their practice. Even the most experienced will learn from the considered balance of explanation, theory and information about practical voice work that Christina Shewell has brought together. The various parameters of the human voice, such as vocal quality, loudness and pitch, have a plasticity that allows them to be changed both involuntarily and as the result of conscious intervention. The reasons why individuals might decide to embark on vocal changes intentionally span the abnormal–normal–superior voice continuum. Those with disordered voices seek remediation for the problems that affect their oral communication so significantly and those with ‘normal’ voices might aim for increased functional efficiency and perceived acoustic beauty. There are no fixed boundaries throughout the continuum, however. As Christina Shewell points out in this book, changing the voice is both an art and a science. All voice practitioners, whatever their disciplines, must base their intervention on a sound understanding of the anatomy, physiology and biomechanics of phonation if they are to practise safely and with maximum effect. In addition, providing evidence for the techniques that we use is becoming increasingly important. If there is no scientific evidence for the effects of the techniques that we favour through experience and long-term use, then we have an obligation to investigate their effectiveness. This concept should apply to all fields of vocal work, not only voice pathology, if we are to provide our students, patients

Forewords ix

and clients with the best intervention that is available. Of course, as the author of this book recognises, many techniques that are in use do not have such supporting evidence, and we have to use what seems to be most helpful from experience. In time, however, being able to select intervention strategies of proven worth would be the ideal situation. Those who endeavour to provide this evidence do not seek to devalue the clinical and artistic skills of the vocal practitioner that are so essential to the best intervention, but to enhance the process by using the best tools. This book is special in the field of voice literature because the author is dually qualified as a speech and language therapist and as a voice teacher. Her extensive clinical and teaching experience results in a text that reflects her insights into the complex processes of changing voices. The importance of the multidisciplinary approach to voice care and pedagogy is implicit throughout the text. The reader, from whatever vocal discipline, will have the opportunity to gain greater understanding of the broader spectrum of intervention than his or her particular field of interest, and will discover numerous tools and strategies by which to achieve vocal change successfully.

Mark Meylan, Singing Teacher In the twenty-first century, vocal anatomy and voice science are an important part of singing teachers’ knowledge, and most singing teachers would place themselves somewhere between ‘imagine inhaling the perfume of a rose and ‘feel your arytenoids working’! Our contact with speech and language therapists, laryngologists, speaking voice coaches, voice scientists and other voice professionals mainly happens at singing teachers’ or multidisciplinary voice conferences, or through articles in professional journals. In any of these situations our exposure is only to one aspect of that particular voice practitioner’s work. So we may gather information on, say, vocal hydration from a lengthy article giving general advice, or from a number-crunched 9-minute PowerPoint presentation featuring 36 female seniors living in an air-conditioned retirement home in a southern state of the USA. From all this we piece together our ‘take’ on this amazing world of voice. Only in a book with, ideally, one author do we truly get more than a snapshot of a voice practitioner and so it is with Christina Shewell. Books on singing teaching are exactly what they set out to be and, although they can be invaluable, serious singing teachers need to broaden their search for valuable, informed and practical information to help guide the decisions that they make and the information that they impart in the singing studio. Christina is a uniquely placed voice practitioner by being skilled, effective and experienced in two areas of the multidisciplinary voice world: speech and language pathology and the speaking voice development. So in Voice Work: Art and Science in Changing Voices the singing teacher has the opportunity to explore two other worlds. With these two disciplines the author is able to offer such treats as ‘Speaking Wonderfully’ in Chapter 28, moving the valuable healthy everyday norm of speech and language therapy into the advanced voice use of the speaking voice coach. Her experience means that she is not afraid to stand up and be counted, and I personally welcome her strong feelings on – for example – the importance of breath as a ‘core foundation for voice work’. There is a wealth of valuable diagrams and photographs here, ranging from trusty old favourites to her own table of breathing muscles – a joy. Her eclectic nature enables the inclusion of her own practical hand photographs for head and neck alignment in the

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Forewords

bodywork foundation section. In her simple yet unpatronising writing, I read an experienced practitioner relaying ‘best practice’, with references to lectures, articles or books that, however esteemed, never spoil the flow. I am encouraged to stretch my knowledge by exploring, among other exercises, the chakras and the sound bath. It is this openness and knowledge of voice outside her specific fields that makes this book greater than the sum of its two parts.

Patsy Rodenburg OBE, Voice Teacher Christina Shewell has written an important and unique book – a book that should be embraced by the voice world and owned by anyone working with the human voice. There often seems to be a division in voice work. On one side of the voice sphere are the spoken and sung voice teachers. They work to excavate, extend and train our magnificent natural voices, and mostly work with professional voice users. In order to be a successful voice teacher you need to have trained your own voice, which takes a minimum of 3 years’ dedication. You also need to learn how to teach, which can take decades of practice. On the other side of this intriguing world are the therapists who work to repair damaged voices and speech muscles with impaired movement. In order to begin to understand therapeutic work, a therapist has had long training in anatomy, neurology and psychology, and then has to achieve years of clinical experience to work effectively. The human voice needs both teachers and therapists, but sometimes these two groups can view each other askance and even occasionally with contempt. This division became very clear to me some years ago when I attended a voice conference in New York. An eminent American voice teacher and coach created an uproar when she declared to the whole conference, filled predominantly with therapists and doctors, that she was tired of listening to presentations from voice experts who had had no vocal training. She considered that they consequently didn’t use their own voices well, and asked ‘Why should I listen to dull and inaudible voices?’. At the same conference, an equally eminent singing teacher showed disgust when she viewed film of the vocal folds in surgery. She interrupted a doctor’s session by stating ‘I don’t want to look at the ugliness of vocal anatomy, I only want to hear the beauty of the voice’. The next day she conducted a singing master class and was criticised by therapists who suggested that some of her singing techniques were anatomically unsound and could damage a singer’s voice. Let me repeat the obvious – the human voice needs both groups of practitioners, and Christina Shewell is uniquely placed and experienced to unite these divisions in our world. She has trained and is recognised internationally as both a therapist and a voice teacher. Her book helps us all to journey to the other side of our world and, because she writes so clearly and with such humanity, this book is not only an essential reference book but constantly reminds us how privileged we all are to work with voice.

Preface

The aim of this book is to offer a meeting point for all those whose work is the repair, improvement, development and exploration of voice along the normal–abnormal voice continuum. The focus is the spoken voice, but many of the ideas and exercises are also relevant to the teaching of singing. There are three main voice practitioners who work with people who want to change their voices in some way: 1. Voice teachers (in some countries known as speech trainers or voice coaches). 2. Speech and language therapists (in some countries known as speech pathologists or logopedists). 3. Singing teachers (in some countries known as voice teachers). At times I also refer to another group, the exploratory voice guides – a term coined for those who lead experiential sessions where people are encouraged to explore their voices using a wide variety of sounds. There are an increasing number of workshops on offer, and the facilitators use a variety of songs and techniques gathered from around the world. The voice practitioner professions are separate and autonomous, but there are areas of overlap where at times one will carry out aspects of another’s work. Other groups – such as drama teachers, dialogue coaches, and theatre, choral and musical directors – also sometimes work directly on the sound of an individual voice, but this is usually part of wider work. There are other professions with work that is invaluable to understanding about the care and quality of the voice, but the involvement of which does not usually involve direct ‘hands-on’ voice work. These include phoneticians, speech scientists and ENT specialists (who may also be referred to as otorhinolaryngologists, laryngologists or phonosurgeons if they have a specialism in voice). There is a wide range of literature for voice teachers, actors and public speakers on how to develop the spoken voice. There are many books for speech and language therapists on the management and treatment of voice disorders, fine texts on developing the singing voice, and an increasing number of books about esoteric aspects of voice exploration and healing.

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Preface

Each of these is written or edited by relevant specialists in their field, but the approach of one profession may not be easily accessible to another. This book has a particular focus on how to problem-solve if a voice is ‘not working well’, and offers a clear philosophy of practical voice work based on a structured way of listening. This is linked to both theoretical knowledge and practical exercises. Stories are given throughout to illustrate what can happen to a voice, and how a voice practitioner can be part of vocal change. Christina Shewell June 2008

About the book

The style aims to be scholarly but accessible, with insights from both artistic and scientific fields. Extensive references are made to research findings and to other writers, alongside stories found to be useful or interesting in my own varied professional voice journey, so the pronoun ‘I’ is used when appropriate. The approach of this book is deliberately eclectic, with ideas and techniques from my experience as a speech and language therapist with special interest in voice, and a qualified voice teacher who has worked extensively with actors, singers and public speakers. As a university academic, I have taught voice and counselling for many years, bridging the art–science divide whenever possible. In the practical voice work section, some ideas are phrased as suggestions on what to do with a client, but many are addressed to ‘you’. This sets the tone of experiential work, because most voice practitioners will have practically explored their own voices. However, this is not a self-help book for people who want to develop their own voices. There are several such books available, and these are best seen as supplements to use alongside work with a practitioner. Few people have the stamina and discipline to work through a silent book of advice and, even when this is supplemented by a DVD of exercises, feedback and encouragement from an ‘outside listener’ are invaluable. When appropriate, references are made to the audio files that are included on the book website, found at www.blackwellpublishing.com/shewell, and they are indicated by the following symbol: I avoid the use of the dual ‘he or she, him or her’, preferring instead to freely use one or the other of these third person pronouns, because both voice practitioners and the people with whom they work cross the gender division. For brevity, the term ‘speech and language therapist’ is generally shortened to ‘therapist’ or ‘SLT’. Voice practitioners vary in the terms that they use for those with whom they work, and these include ‘client’, ‘patient’, ‘pupil’ and ‘student’. Although all these may appear at times, the book generally uses the term ‘client’, a word that the Oxford English Dictionary defines as ‘a person using the services of a professional person or organization’. Our power and effectiveness in working with voices are a mix of the practitioner’s personal experience and qualities, the speaker’s needs and personality, and the practical work chosen. The book’s focus on vocal skills takes for granted that an individual’s life and emo-

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About the book

tions are at the foundation of the voice; the way we ‘live our sound’ is shaped by our childhood background, inherited personality traits, the way life treats us, the moods we experience and the world in which we live. There are six parts in the book: 1. Part 1: Considering voice work describes the different voice practitioner groups so that other professionals can learn something of their background, and looks at the different philosophies and shared methodologies of practical voice work. 2. Part 2: Investigating voices describes ways that we can find out about a voice, from physical, acoustic and perceptual perspectives. 3. Part 3: introduces the Voice Skills approach. This offers a simple ‘common sense’ way of describing voices under eight core voice skills. A new perceptual scheme is introduced that can be used by therapists, voice teachers and singing teachers. 4. Part 4: the nine chapters of Voice work foundations are based around the core voice aspects described in Part 3. These offer core theory relevant to the later practical work. 5. Part 5: Practical voice work offers a wide range of ideas, specific techniques and exercises. These relate to general body and voice care and to the eight voice skills. This section also discusses the emotional aspects of voice work. 6. Part 6: Voice disturbance describes the main voice disorders, and looks at the kind of vocal disturbance that can occur in working life, with specific focus on the acting and singing voice. At the end of the book you will find extensive reading references in the Bibliography, and details of a number of relevant websites in Appendix I.

Acknowledgements

For a generous writing grant: Eric Adams and the Barrow Cadbury Trust. For the gift of her original painting as book cover design: Pip Benveniste. For encouragement and quiet sanctuaries in which to write: Alison and Michael Mayne; Andy Paterson and Zanna Beswick; Susan and Adrian Fry; Jane Maxim and Stephen Barnard; Michael and Freda Fisher. For their particular contributions – special thanks to Dawn French, Lesley Mathieson, Mark Meylan and Patsy Rodenburg; and to Dr Evelyn Abberton, Professor Adrian Fourcin, Evangelos Himonides, Professor Robert Sataloff and Samantha Wallace. For a most generous sharing of knowledge, experience or support: Dr Alison Bagnall, Dr Jan Baker, Noelle Barker, Dr Janet Mackenzie Beck, Cicely Berry OBE, Professor Martin Birchall, Ed Blake, Lynne Booth, Annabel Bosanquet, Jane Boston, Margaret Braund, Mr Richard Canter, Professor Paul Carding, David Carey, Helen Chadwick, Jayne Comins, Joyce Cook, Rocco Dal Vera, Mr David Garfield Davies, Catriona Dixon at Wiley-Blackwell, Sarah Dunant, Jill Gabriel, Caroline Gant, Katarina Gildebrand, Juliet Grayson, Chloe Goodchild, Duncan Grossett, Andrew Hambly-Smith, Mary Hammond, Mr Tom Harris, Sara Harris, Dinah Harris, Professor Markus Hess, Professor Rheinhart Heuer, Paul Hill, Professor Robert Hillman, Professor David Howard, Dr Eva Holmberg, Louise Holland, Sophie Holland, Matt Hood at Equity, Barbara Houseman, Mark Huckvale, Lizzie Hutchinson, Sandra Inglis, Janet Jones, Sue Jones, Gillyanne Kayes, Sue Kuhn, Jacob Lieberman, Kiereen Lock, Myra Lockhart, Jeanie LoVetri, Rachael Lowe, Dr Stephanie Martin, Noel McPherson, Liz McNaughton, Melanie Mehta, Masashi Minagawa, Yvonne Morley, Dr Steve Nevard, Ellen Newman, Yioda Panayiotou, Mario Petrucci, Judith Phillips, Amaryllis Pye, Dr Gillian Rice, Mr Philip Robinson, James Roose-Evans, Debby Rossiter, Mr John Rubin, Dr Alison Russell, Mr Mike Saunders, Professor Klaus Scherer, Ann Skinner, Southmead Hospital ENT department, medical library and the speech and language therapy department, Siobhan Stamp, Andy Stephens, Janet Swan, Mr Paul Tierney, Cathy Timothy, Professor Ingo Titze, Janie van Hool, Stevie Russell and the library of the Department of Human Communication Science University College London, Mr Robert Slack, Mark Vaughan, Jack Vaughan, Anna Vaughan, Andrew Wade, Mr John Waldron, Morwennna White-Thomson, Professor Graham Welch, Rachael Wilkie, Dr Jenevora Williams, Joe Windley, Cynthia Whelan, Claire Wonnacott. And warm appreciation to all my clients from whom I continue to learn so much.

Part 1

Considering voice work

Voice Work: Art and Science in Changing Voices. Christina Shewell © 2009 Christina Shewell. ISBN: 978-0-470-01992-4

Chapter 1

The voice work continuum

Background music A woman is walking down the street. You recognise her as a famous fashion model and are impressed with her grace and beauty. As she passes, she takes out her glamorous mobile phone and you hear her speak. Her voice is tight, rough, nasal and monotonous, and suddenly she seems far less appealing. A man stands up to speak at a conference. He is unprepossessing in appearance; his face is round and shining, thick spectacles obscure his eyes, his dull grey clothes are rumpled and ill-fitting, and he looks nervous. But, when he starts to speak, you are captivated by the warmth and energy of his voice; his deep, resonant sound somehow draws you in. ‘What an interesting person,’ you think, ‘I’d like to know him better.’ We can change the gender of the speaker in both these examples, and it will still work. The point is that, although consumer society is obsessed by the visual image, and we are bombarded every day by pictures of the boy beautiful and the girl luscious, there is still some unconscious sense that what we hear in a voice reflects the true personality of the person, and has a deeper truth than what we see. Most people take their voices for granted. They seem to flow naturally from our intellect and emotions, but, because they are the background music to our words, they have a powerful, and often unconscious, effect on listeners. There is a direct parallel with the typography that shouts out at us every day. Advertisers have long known that the font that they use to describe their goods will have an effect on those seeing it. You may be drawn to buy antiques sold to you like this: FINE ANTIQUE AND SECOND HAND FURNITURE BARGAINS! but would expect a different ‘mood lettering’ if you were to be attracted to a new computer shop: ALL NEW PCS AT HALF PRICE Reverse the two and, although you might not be aware of it, you would be picking up a different sort of message:

Voice Work: Art and Science in Changing Voices. Christina Shewell © 2009 Christina Shewell. ISBN: 978-0-470-01992-4

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Voice Work: Art and Science in Changing Voices

FINE ANTIQUE AND SECOND HAND FURNITURE BARGAINS! ALL NEW PCS AT HALF PRICE So it is with voices. Voice is a two-way psychosomatic phenomenon; it is shaped by the speaker’s psyche (our personality and current emotions) and soma (the health, shape and usage of our bodies). As the bridge between our inner and our outer worlds, it also affects the psyche and soma of the listener. No matter how interesting a speaker, if his voice is tense, monotonous and rough with a ‘whining’ nasal tone, it may affect the tension in your own body. You don’t feel good listening to him, and may want to get away from that sound as soon as possible. If a conference lecturer has little voice variety as she speaks for half an hour, the lack of energetic change in the voice is likely to make the audience feel heavy and listless – particularly in that challenging after-lunch slot, or towards the end of a long day. Conversely, there are qualities that we hear in sung or spoken voices that can make us feel good. The open, powerful voice of a female gospel singer with its rich resonance and huge pitch range gives you a sense of strength and energy. On a crowded bus, you may turn to look at the man whose deep husky tones are attractive with their tone of intimate evenings. The high ethereal notes of the chorister singing the Allegri Miserere may make you feel as if your heart is lifting. I deliberately use images because sometimes the effect that a special voice has on our feelings and physical sensations can be expressed only in such words. Through vocal sound we express our physical, psychological, social and spiritual lives, and our voices grow and change with us in the dance of our individual life.

Who wants to change their voices? We breathe and we voice – the first two activities of our life. Spoken voices feel like an extension of personality, flowing effortlessly out of our heads and hearts, our thoughts and feelings. For many, working on the voice would seem like cosmetic indulgence at best and false betrayal at worst. Yet every year thousands of people do work to extend, change or mend something about how they sound. Many of those people are professional voice users for whom the voice is a vital part of their work. Actors work with a voice teacher to develop the power and subtlety of their voices, and even an experienced singer may go for regular lessons to continue to develop skills and repertoire. Many non-professional voice users enjoy extending and developing their voices in lessons or in choirs. In the latter, they can feel the power and exhilaration of their voice streaming out in the company of others. Some people have a sense that their voice ‘lets them down’. It does not work in the way that they want, and a busy call centre operator or over-stretched teacher may seek help because he is regularly losing his voice towards the end of a day. For some the spoken voice does not seem right for what they feel is their ‘true self’. A senior manager in a company may recognise that her voice does not reflect her real authority and work with a voice trainer to find that ‘true’ power. Voice teacher Patsy Rodenburg (1992) makes an important distinction between the natural and the habitual voice. The latter may have become laden with tensions, defences and strain and, if ‘liberated’ by voice work, the speaker is likely to feel that his voice is healthier and that it better reflects his personality.

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Sometimes there is an actual voice disorder. The voice may be affected from birth, as is the case for many children born with deafness, cerebral palsy or a cleft palate, whereas other people develop an abnormal voice as a result of use or illness. This often leads them to an ear, nose and throat (ENT) specialist who may prescribe medical treatment or a course of voice therapy.

Voice problems and voice disorders ‘Voice problem’ is a term used by the general public, whereas the diagnosis of a ‘voice disorder’ is made in the clinical world, if a speaker or singer is referred for a medical opinion. There is often, however, a blurring of these distinctions. Daniel Boone (1991) describes a voice problem as occurring when ‘things that we do or fail to do prevent our natural voices being heard’. He estimates that around 25% of the population may be ‘displeased with the way that they sound, and with the way that their voices affect their careers and social lives’. Using 2003 Census Bureau figures would mean that a staggering 72 million Americans and 14.9 million British men and women were unhappy with their voices. Of course only a tiny proportion of them are going to seek help to change their voices but that is still a huge number of self-critical speakers! Boone (1991) describes a voice disorder as ‘something that needs to be treated by a specialist’. If a speaker has unexplained hoarseness that has lasted for more than 2 weeks, he should go to see his local doctor; if the doctor is concerned, she will refer the client to a hospital ENT department. Some people live with their hoarseness for months or even years without seeing a doctor, but there is always a risk – however small – that the husky voice may be caused by something serious that needs urgent treatment.

Voice story: librarian Some years ago the librarian at my university department asked me if I could give her some exercises to help her voice. ‘I’m ashamed to say that I strained my voice singing at a rugby match last month and it’s still croaky.’ It would have been easy to offer practical advice and exercises. But she was in her mid-50s and an ex-smoker, and I knew that there was a risk that this was not a simple voice strain. I suggested that she should first of all get a check with a specialist, sooner rather than later, to see that the yelling had not done any damage. Her family doctor referred her to the local ENT department, and 6 weeks later she told me that a small cancerous growth had been found on one vocal fold, which would be treated by radiotherapy. This is unusual, but it is a warning to voice practitioners to recognise the difference between voice problems and voice disorders and that, if they have any concerns, a medical check should be made. A lifetime’s dissatisfaction with a voice that goes squeaky when nervous, short-term huskiness after flu or karaoke singing, or a sound that is not interesting in lectures rarely needs a visit to a medical specialist. But long-lasting hoarseness or a new vocal limita-

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Voice Work: Art and Science in Changing Voices

tion may be a warning sign that something is wrong with the vocal folds or with voice muscle function. Such changes need a medical examination, at whatever age the speaker may be. Chapter 27 describes the voice disorders that can occur.

The voice practitioner groups Although there are increasing opportunities for practitioners in parallel fields to get together, some know little about the other practitioners. We look at the training of each profession, the typical client range with whom they may work and how you might find a local practitioner.

Speech and language therapists/pathologists This profession assesses and works with people of all ages who have difficulty with communication or swallowing. Most students follow an undergraduate or postgraduate course with both academic and practical strands, and generally graduate with a science-based qualification. In many countries courses and therapists are regulated by a professional organisation; in the UK all speech and language therapists (SLTs) must be registered with The Royal College of Speech and Language Therapists (RCSLT) and the Health Professions Council (HPC), and their professional name is protected in law. The national organisations generally have a directory of members so that clients can find a local clinician, who may work privately or in a state-supported service such as the British National Health Service. Those who specialise in clinical voice work give voice therapy, but are not referred to as voice therapists. Some clients will have undergone a laryngeal examination and be diagnosed with a voice disorder, whereas others – perhaps with a hearing impairment, learning disability, cleft palate or the neuromuscular problem of dysarthria – will have a voice disturbance that is wider than phonation quality alone. It may surprise other voice practitioners that there is no specific training for SLTs to become voice specialists. A few follow an MSc in voice, but most learn their practical skills by working ‘on the job’ alongside a more experienced colleague, gathering new knowledge in a piecemeal fashion. In the UK few graduate courses offer experiential voice work, so therapists may never have worked on their own voices; in Sweden, with its excellent reputation in the field of voice disorder research, the logopedists receive many hours of voice training. In 2000, I asked 110 SLTs how much experiential voice training they had received during their university course: 48 had none; 39 had a minimal amount (1–6 hours); 16 had a moderate amount (7–15 hours); and only 7 had an extensive amount (16 or more hours). These results are depressing because an important aspect of learning about voice is to work our own voices and then reflect upon the experience, linking this to the theoretical knowledge now available (Shewell 2000b).

Voice teachers/voice coaches Voice teachers work with the spoken voices of actors and other professional voice users, and with those who want to develop the power or the quality of their ordinary spoken

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voice. They often also work with linked communication issues such as personal confidence and ‘presence’. Historically, voice teachers developed from the profession of drama teaching, or acting itself, and this is still a route for some voice teachers. There are, however, an increasing number of formal training courses around the world, and two Masters degree programmes in the UK. Some well-known voice teachers have set up specific training courses in their methods e.g. the Linklater, Lessac and Fitzmaurice voice approaches (see website information in Appendix I). There is as yet no regulating body or registration for this profession, so anyone can call herself a voice teacher. Finding a good local voice teacher can be difficult for a prospective client or interested fellow voice practitioner who does not know where to look. A phone call to a drama college will sometimes access a contact, and some voice teachers advertise in the commercial pages of the local telephone book or regional newspaper. The British Voice Association (BVA) provides a list of voice teachers for enquirers, and some national organisations, such as VASTA (the American Voice and Speech Trainers Association) have excellent geographically organised databases of teacher details and credentials. Much voice teacher work is with student or professional actors in theatre, TV or film. The philosophy of voice development is generally that it takes time, ideally with long periods of solid exploration and practice. This is in marked contrast to most voice therapy where the average treatment for a voice disorder is around four to eight sessions, with work clearly goal oriented and as efficient as possible. Many voice teachers also work with others who want to protect or change their voice in some way. These include both professional voice users (described in Chapter 28) and ‘ordinary’ people for whom voice work may be part of training in confidence and communication skills. Some voice teachers set up companies that specialise in business training, with lucrative regular contracts with big corporations or institutions. Most, however, gather freelance work from a variety of sources, often balancing that with some sort of regular teaching commitment. Working as a voice teacher can bring contact with an enormously mixed client group. My work has included inaudible public speakers, anxious members of the police force, exhausted teachers, tired telephone operatives, broadcasters with sore throats and vocally challenged members of the government. Many voice teachers use their own voices in a public forum and this too can vary; I have given poetry readings, led a chanting session down an old flint mine and provided my voice for a helicopter warning system!

Singing teachers Singing teachers of course work to develop the singing voice in individual or group classes, or directly attached to professional shows. They may specialise in one particular genre of singing, such as classical, musical theatre or pop, or work with many. Teachers vary enormously in their style of singing and in their own background. Most will have had some sort of musical training, be able to read music, have a wide repertoire of songs, and be familiar with many technical aspects of music and singing. Many teachers will have enough keyboard skills to be able to accompany their students, but some use tapes. Successful teachers may have a pianist as separate accompanist but this is less usual.

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Voice Work: Art and Science in Changing Voices

Although singing teachers may have been performers, this need not be so. Many general musicians offer singing lessons; traditionally English cathedral choral directors, responsible for the developing voices of young choristers, train as organists before acquiring their knowledge of the sung voice. As with the voice teachers, there is no certification needed for singing teachers, so anyone can set herself up in the field. There are some training courses available but options are limited. Singing voice specialist Jeanie LoVetri writes ‘American colleges and universities do offer pedagogy courses, but they are random and not required. The only degrees available in vocal pedagogy are for classical singers and they are just available as doctorates’ (personal communication, 2007). There are many excellent singing teachers, but they are often open in their concern that the lack of any regulation allows inadequate teachers to work badly with trusting students. Any good singing teacher is deeply committed to bringing out the best possible voice in a student and to knowing as much as possible about the field. Knowledge can be shared through an organisation such as the Association of Teachers of Singing (AOTOS) in the UK, the National Association of Teachers of Singing (NATS) in the USA and similar organisations in other countries. All offer publications, access to other practitioners and a range of shared study days and conferences, and can provide valuable information to other voice practitioner groups. A singing teacher will communicate to students at least three equally important core aspects of singing: the physical mechanics of singing, core techniques to develop and protect the voice, and relevant knowledge and practice in the areas of music and performance. Whatever the singing style, he will have a good knowledge of vocal anatomy and the physiological practicalities of the singing voice. I had one singing lesson from a teacher who instructed me to ‘sing from my pharynx’, while pointing to the middle of her forehead. As singing teacher, Liz McNaughton writes ‘we often have the feeling that the sound comes from a totally different place from that which is scientifically possible. The semantic aspect is one of the most confusing problems in singing pedagogy’ (personal communication, 2006). Using images in any voice work is fine, so long as the student has an adequate sense of the physical reality of voice production to avoid damage and safely liberate new vocal power. Although AOTOS and NATS both offer connections to local singing teacher members, there is no compulsory register, and it is often local newspapers, library notice boards or personal contacts that bring an aspiring singer to a teacher. It may then be difficult to find out details of a teacher’s background and whether that person specialises in any particular singing genre.

Exploratory voice guides I use the word ‘guide’ because many practitioners see themselves as travelling with their clients on a journey of voice. Practitioners come from a wide variety of backgrounds and may be musicians, singers, voice or singing teachers, meditation teachers, healers, actors or simply passionate about voice. They do not see themselves as experts who instruct, but offer an experience of voice from which people will benefit. There are an increasing number of people who run open sessions for those wanting to explore their voices. These may be one-

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off day workshops, regular classes, or form part of a creative or recuperative time away on a longer residential course. Some practitioners work with people on an individual basis, and many see voice work as a power for psychological and physical healing. Through local advertisements, the ordinary person can find a person, place and space where they can learn the chants and songs of other cultures and spiritual practices, or open up new power by practical voice exploration in exercises and music. The ‘singing for nonsingers’ groups have enabled many people to find the joy of singing with others, and to do things with their voices that they may never have done before. I often suggest that SLT colleagues interested in voice work take a risk and try out such experiential work on their own voices. It is important to be a little cautious, however. A group workshop often encourages amazing vocal sounds, but, although the human voice is generally a resilient and flexible instrument, it may not be physically or emotionally safe for some voices to swoop, shriek, yell and soar with total abandon. Making wild sounds can open up wild feelings and some practitioners go very deep with people who may be vulnerable, offering little or no after-care. Others, however, do provide ongoing support as an integral part of a voice work process, designed to access artistic or personal growth. The work of the Roy Hart Theatre and the voice movement therapists lie within this tradition, and is described in Chapter 15. Deep voice development work should be carried out only by practitioners who are trained, experienced and responsible. Almost all psychotherapy and counselling disciplines have safeguards for clients by insisting that therapists have supervised client work and on-going supervision. Only when a similar protection is in place should a voice practitioner feel confident to delve too deeply into another’s emotions via the voice.

Voice story: Abiona Abiona was 25. As a child in Nigeria she was acutely shy and this continued when she arrived in England as a young teenager, when she went through several years of anorexia. She recovered but remained self-conscious about both her body and her feelings. She was referred to me in my role as a voice teacher, as her spoken voice was so habitually high, quiet and breathy; she wanted to sound and feel different. My voice work had only limited success so I suggested Abiona see a voice movement therapist, with whom she worked extensively. She found the process of exploring her voice and accessing a new vocal strength and resonance to be a crucial part of her personal growth. Her spoken voice became deeper and more resonant; she heard this vocal power as she talked and felt stronger with this as her own personal background music.

Different voice practitioners: one client Particular clients need to see particular voice practitioners. Actors need to train with voice teachers, singers with singing teachers and clients with a voice disorder should always be treated by SLTs. For some clients, however, fate may offer a number of options for voice work. Here is an example.

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Example 1.1 School teacher Alison is a 34-year-old primary school teacher who recently took a deputy head post. Here her class of 7 year olds are very noisy and need a lot of calm discipline. For the first time ever she feels that her voice is simply not up to the job, and by each Friday, she is ‘pushing’ to be heard and her neck actually aches. She does, however, recover completely every weekend. Alison admits that she does not know how to unwind in the evenings; her husband works in London all week, and she tends to work late at her computer.

Let’s look at four possible action scenarios.

SLT route Alison may initially go to her doctor, and then to a local ENT specialist, who finds no structural abnormality in her throat and suggests voice therapy. The SLT gives her advice on general voice care, including drinking enough water, avoiding noisy environments and reducing her tendency to habitually clear her throat. He gives her four sessions of voice therapy, with work to power her voice better and reduce her pattern of over-tightening in the laryngeal area. He also talks with her about general stress management. Alison’s voice becomes stronger and her weekly problems disappear.

Voice teacher route Let us suppose that Alison does not go the ‘doctor’ route. Instead, she talks to a friend who does a lot of amateur dramatics, who advises her to contact a voice teacher described as ‘a whiz when he worked with the actors on our last production’. Alison has 10 sessions with this teacher, and enjoys the exercises and dramatic texts that he sets her. In both her teaching and her ordinary life, she begins to find a new strength and openness to her voice, and her voice strain disappears.

Singing teacher route Alison’s husband might give her a course of singing lessons as a surprise Christmas present, something that he knows she has always wanted to do, and that he thinks might help to strengthen her voice. If the teacher is good, the opportunity to let her voice soar, swoop, extend and strengthen in safe singing sessions could start to give Alison some experience of unstrained voice use, and she may find new healthy vocal techniques to find a stronger voice for her teaching. The danger is only that, if she joins a big choir where she cannot hear herself, she might strain her voice by singing too loudly or too high, and would then find her voice problem getting worse.

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Exploratory voice guide route The fourth possibility is that Alison reads about evening classes in yoga and chanting, which she decides to join with a friend. Through the regular stretching and relaxing of the yoga asanas (positions), and the deep breathing and unstructured voicing, Alison finds a way to release some of her excess tension and stress. She accesses a deep, powerful voice in the Tibetan overtone chanting, and talks with the voice workshop leader about how she can better project her voice at school.

Getting together These hypothetical examples introduce a core theme that runs through this book – that the voice practitioner groups provide a rich pot-pourri of approaches and techniques for voice work. Although they have different training, aims and client groups, there is much in common, and clearly opportunities for sharing experience would seem to be a good idea. In my first training, as a speech and language therapy student, I was taught a vast amount of anatomy, physiology, phonetics and acoustics, but, when I left my course, all I knew to do with people who had voice disorders was that I should get them to breathe deeply and to hum. It was not clear to me why either of these techniques might help, and my therapy was on a very hit-or-miss basis – with probably far more missing than hitting in the early days. Meanwhile my drama, singing and voice teacher colleagues were learning a huge range of exercises to do with students, but often lacked the basic anatomical or psychological knowledge that might have made their work easier and more accurate. Nowadays increasing numbers of voice practitioners recognise the holistic nature of voice work, not isolating one approach from another, but combining ideas to suit the specific need. All voice work techniques then become wider and richer.

Shared literature Voice practitioners, laryngologists and speech scientists can access each other’s knowledge through books and the internet. Some are designed to reach a range of practitioners. Robert Sataloff’s (1997 and 2005) Professional Voice: The science and art of voice care is primarily written in the scientific tradition, but contains a vast amount of knowledge valuable to many practitioners. The Vocal Vision, edited by voice teachers Marion Hampton and Barbara Acker (1997), is a valuable collection of practice-based writing from a range of voice practitioners, as is Well-Tuned Women (edited by Frankie Armstrong and Jenny Pearson 2000). Many books are, however, seen as belonging to a particular area of voice work, so that other practitioners, who would benefit from their ideas, may never see them. My own chance discovery of two ‘singing teacher’ books – Meribeth Bunch (1982) Dynamics of the Singing Voice and James C. McKinney’s Diagnosis and Correction of Vocal Faults (1994) – gave me information and practical ideas that I would never have found in voice therapy texts. More recently, Janice Chapman’s (2006) Singing and Teaching Singing richly fulfils its subtitle as ‘a holistic approach to classical voice’ and offers many insights into both the

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philosophy and practice of working the voice. The literary contributions to theatre voice work of Cicely Berry, Kristen Linklater, Patsy Rodenburg, Barbara Houseman, Michael McAllion and their older antecedents contain a mass of practical voice exercises; they are valued by voice teachers, yet rarely read in the clinical voice therapy or singing teaching. In the world of self-help for voice, Daniel Boone’s (1991) Is Your Voice Telling on You? and Cicely Berry’s (1994) Your Voice and How to Use It offer a wide range of valuable ideas and exercises that are highly relevant for voice therapy work, and have implications for the care of the voice in singing. Core reference texts on voice disorders by Aronson (1990), Boone et al. (2005), Colton and Casper (1996), Mathieson (2001) and Sataloff (1997) offer explanations, diagrams, photographs, norms of voice, case stories and a wealth of facts that can clarify confusion and extend any practitioner’s range of knowledge.

Voice organisations Many professionals from the artistic, clinical and scientific fields of voice share knowledge and practice through the forum of the multidisciplinary voice associations that exist in many countries. They offer opportunities to learn from presentations, lectures, demonstrations, workshops and informal contacts with different sorts of ‘voice workers’. Below you see some of the major examples of such organisations; such a list cannot be all inclusive, but will give some idea of the options available for eclectic vocal contacts. One of the oldest multidisciplinary voice organisations is The Voice Foundation. Founded in the United States in 1969, its goal is ‘to understand the voice and improve its quality and care’ and to solve voice problems. It funds research, promotes public education and aims to raise the professional level of voice care. Its membership is international and, at its huge annual symposium in Philadelphia, voice practitioners meet to share knowledge and practice. Its publication, the Journal of Voice, has many articles of interest to all groups. Although written in serious research style, many papers are easily readable, and contain fascinating new findings, or indeed proof of what we have always suspected! In the UK, the British Voice Association (BVA) describes its remit as the encouragement of a healthy voice, vocal skills and communication. It recognises the human voice as an ‘essential element of our communication and well-being’, and states its belief that all those with voice problems, from severe pathology to subtle difficulties of artistic performance, are entitled to the best care available. Membership is international and open to anyone who is interested in voice. It organises regular courses and conferences and its journal, Logopedics Phoniatrics Vocology, is free to all members. Also in the UK, the purpose of the Voice Care Network UK (VCN) is ‘to help people to keep their voices healthy and to communicate effectively’ and it supports all those whose work involves voice use. The VCN provides workshops, seminars and coaching, and has a small range of practical voice publications. It has always emphasised the need for voice practitioners to deepen their understanding of voice by developing their own voices as well as knowledge acquisition. The Australian Voice Association (AVA) also has a multidisciplinary membership from the artistic, clinical and scientific fields of voice. Members receive an informative and entertaining regular newsletter, and the refereed journal Australian Voice.

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Many other countries have their own voice organisations. EVTA is the European Voice Teachers Association, and describes itself as a ‘non-political, non-profit making association concerned exclusively with artistic, pedagogic and scientific aims’. Although its focus is on singing, it too aims to promote communication between its members and related disciplines world wide, and it holds conferences, seminars and meetings for the exchange and dissemination of ideas and information. Any voice practitioner planning to work in a new European country would find EVTA’s website a useful starting point. CoMeT (Collegium Medicorum Theatri) is a somewhat different international voice organisation in that membership is limited to those elected by members. These may be physicians, scientists, voice coaches and voice pathologists from different cities of the world, who are connected with major theatres, operas or conservatories, or who have demonstrated special dedication to the physiology and pathology of the voice in singers and actors. Headed by Professor Inge Titze, the National Center for Voice Speech in Denver describes itself as ‘an interdisciplinary, multi-site team of investigators dedicated to studying the powers, limitations and enhancement of human voice and speech’. The team includes scientists, clinicians and educators who have backgrounds in vocal performance, computer science, speech–language pathology, physics, medicine and other disciplines. Among their varied activities, they host a summer vocology institute each year. A ‘vocologist’ is defined as ‘any person who habilitates vocal behaviour – a speech and language pathologist, otolaryngologist, singing teacher or voice coach’. Titze (1992) has suggested that this new specialty be based in speech pathology departments but closely linked to theatre and music departments. All these organisations facilitate meetings of different voice practitioners, where there are frequent differences of opinion about vocabulary and methods. There is also an excitement as practitioners find the answers to long-standing puzzles, or extend their techniques into new areas of the continuum of voice.

The continuum of voice work Vocal function, and the nature of voice work, can be pictured as a continuum – from socalled normal to abnormal voice, and from aesthetic to therapeutic voice work (Figure 1.1). I use the term ‘so-called’ before the word normal, because there is considerable variation in normal voices. ‘For most voice quality parameters, there is no distinct border between what is normal and what is pathological. Instead there are degrees on a scale’ (Hammarberg and Gauffin 1995). Voice practitioners can be seen as functioning at different points along that scale, but have the option to move along it in either direction at certain times with certain clients. There are of course huge differences among a farmer who is struggling to produce a clear voice after thyroid surgery has left her with a paralysed vocal fold, a musical theatre singer preparing for a role in ‘Evita’ and an actor working to develop the voice needed to play King Lear. Each will need specific voice work but there are underlying principles of voice management and use in common. While respecting our own limitations and the skills of other voice practitioners, the construct of a voice continuum allows us to consider what is common to a healthy functioning voice, and the wide range of techniques from other voice professions that might be useful in our own work.

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NORMAL VOICE

ABNORMAL VOICE

AESTHETIC DEVELOPMENT VOICE WORK Singing teachers

Singers

Actors

THERAPEUTIC VOICE WORK

Spoken voice teachers Exploratory voice guides Public speaker

Person with voice strain

SLT voice therapy

Person who has had larynx removed

Figure 1.1 Diagram showing continuum of voice work and practitioner group with client examples.

ARTISTIC APPROACH

Exploratory voice guides Voice teachers Singing teachers NORMAL VOICE

ABNORMAL VOICE SLT voice specialists ENT specialists Speech scientists

SCIENTIFIC APPROACH

Figure 1.2 The art–science axis in voice work.

We can also consider voice practitioners as working within the different philosophical backgrounds of art and science. The Chambers Twentieth Century Dictionary (Geddie 1971) defines these. Art: a practical skill, or its application, guided by principles; application of skill to production of beauty and works of creative imagination. Science: knowledge ascertained by observation and experiment, critically tested, systematised and brought under general principles; a skilled craft; a trained skill.

It is often suggested that terms such as ‘intuitive, experiential and spontaneous’ belong to the artistic approach, whereas ‘analytical, empirical and structured’ are part of scientific method (Figure 1.2). But great art involves significant craft and structure, and the intuitive and spontaneous invariably play an essential part in scientific thinking. The words ‘principles’ and ‘skills’ are common to both definitions.

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The art–science dichotomy has long been recognised in the voice practitioner world. In a panel discussion about the integration of voice science, voice pathology, medicine, public speaking, acting and singing, Colton (1994) said that in the 1970s ‘the scientist failed to appreciate the art of singing and the sometimes vague terms designed more to motivate and inspire a student or professional, than to explain a concept’. Then, he said, ‘we began to understand each other’s terms’. There is an enormous range of solid scientific research that is highly relevant for many aspects of voice work, and this continues to increase. But much of this can still be difficult for non-science-trained voice practitioners to interpret, whereas speech scientists can still find some of the imaginative voice work terms mystifying or infuriating. There are an increasing number of speakers and writers who make the field accessible to readers from both backgrounds, with no patronising of either scientists or artists; accurate and respectful translation is a worthy activity that diminishes neither field. Verdolini (1997) described how voice trainers and speech and language pathologists/ therapists ‘tend to talk different languages’. The ‘thought-tools’ of the former ‘are often predominantly intuitive . . . the speech pathologist’s tools are often predominantly analytical’. She says that their focus of concern is different because ‘theatre trainers have usually focused on the development of aesthetic and expressive capabilities across a very wide range of human emotions and situations. Speech pathologists have usually focused on restoring impaired voice and speech to normal status, for a comparatively limited repertoire of tasks’. This divide is also described in the singing teacher profession; Gullaer et al (2006) describe the view that there are mechanists and empiricists in singing coaching. The former believe that vocal control should be conscious, direct and science driven, whereas the latter feel that singing is best taught with indirect methods and mental imagery. There are some simple general statements that can be made about the art–science bias of the different voice practitioners. Speech and language therapists working in voice have solid science-based training, and tend to use mainly explanation and direct technical instructions much more than images. The use of prose and poetry texts in clinical work is usually limited to certain specific examples published in voice therapy material. Most therapists use some sort of instrumentation in their voice work, and are increasingly expected and required to use ‘evidence-based’ practice – testing and proving the efficacy of their therapeutic intervention. Voice teachers and singing teachers use both exploratory and direct instruction methods. Spoken or sung text is core to their work. They use imagination and imagery in their classes and vary in their incorporation of anatomical explanation. The proof of the effectiveness of their work is in the sound and success of their students; they have not generally been required to carry out formal research, although there are signs that this is changing in some singing and acting courses. Exploratory voice guides use almost entirely experiential activities in their work, and any evaluation of its effects lies with what their clients feel and say – and whether they come back for more. The clinical emphasis that research should shape practice has been a philosophical difference between the arts and science voice worlds. This will probably continue, because we are unlikely to be able to test and prove the specific effectiveness of each technical and imaginative exercise used by voice and singing teachers. However, there have been a number of studies on techniques that are amenable to testing. In 1994 Stemple et al. used vocal

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function exercises designed to ‘strengthen and balance the laryngeal musculature and to balance airflow to muscular effort’ with women with normal voices, and found that these had a pronounced effect on their ‘phonation systems’ compared with a placebo group. Since then there have been increasing research in the field, and Stemple (2000) describes this in his comprehensive book.

Working along the continuum There is a tendency to describe the world in bipolar terms – art/science, masculine/feminine, active/passive, yin/yang, old/young, and many more. Of course we do need to see things as separate, but the meeting point of two opposites can be a place of interest and creativity. Here we find an integration of two methods, two ways of thinking and two qualities. Poet and physicist Mario Petrucci (2006) writes ‘science and art are kissing cousins. . . . Both the scientist and the artist ask deeper questions of what is superficially observed; in their respective ways, they each pay the world full attention’. American speech–language therapist Janina Casper (2007) applies this recognition to clinical voice work when she writes: ‘Is voice therapy an art or a science? My answer is a resounding YES. I do not believe it can be one or the other to be effective. It has to be both.’ All voice practitioners have a choice to use both artistic, imaginative, experiential exercises and scientific, structured, technical instructions – a mix of intuitive and analytical tools. DeBoer and Shealy (1995) wrote ‘together voice science and voice art form a continuum that is highly technical and medical at one extreme, and aesthetic or abstract at the other, affording a wide range of approaches to vocal transformation’. They commented that although in the last few decades there has been much application of scientific awareness to voice teachers, there was far less written about the way that the artistic approach to voice work can feed the scientific aspects. To counter this, they carried out an interesting research study that looked at the effects of 7 weeks of singing lessons on the clinical and perceptual skills of speech and language pathology graduate students. Following the singing training, they found that there was a significant improvement in: • the students’ ability to perceive clients’ voice characteristics • their ability to apply relevant experiences from the voice lessons to their clinical practice • their own voice quality in singing.

Example 1.2 Analytical and experiential approaches in voice work Janet is a second year singing student at a major music college. She has a fine high soprano voice and is described as having a ‘wonderful musicality’. However, her teacher says Janet’s spoken voice sounds ‘backed and tight’; this quality increases when she has to jump from low to high pitch. Although she can improve this with exercises, there is no carry-over into ordinary singing. She also notices that she is sometimes hoarse after talking over a noisy background in a pub or a party.

The Voice Work Continuum

17

Let’s imagine that a voice practitioner (we don’t need to specify which profession) is working with Janet. He wants to release that throat tension, and to lessen the sense of the resonance as being ‘held’ in the back of the mouth.

Analytic The practitioner shows Janet a diagram of the mouth, and a video of a vocal tract in action during singing. Here she can clearly see the significant size of the tongue, and its relationship to the whole throat area. The practitioner gets her to feel how much she is bunching and pulling back her own tongue, and to identify her hyoid bone and larynx, and their movements. He takes her through a series of exercises, discussing and explaining what is happening in her throat. By the end of the session, Janet thinks differently about her voice muscles and feels a new sense of openness in her throat. She learns how her lips can tingle when she hums a long mmm. Our voice practitioner explains that this shows she is able to let some vibrations move against her lips, thus ‘placing’ her voice further forward in her mouth. He gives her a few exercises to practise in the week before they meet again. In this approach, the aim is to raise vocal behaviour to intellectual consciousness, adjust the style, and then let it drop back into unconsciousness, where it belongs. This way of eliciting change is cognitive, structured, goal directed and organised, often utilising scientific methodology.

Experiential We can also learn through the experience of physical or vocal change; this then becomes a part of a new way of moving or voicing, without immediate intellectual recognition or reflection. In this, the voice practitioner might instead say to Janet (taking time to explore each action): ‘Stretch your arms high above your head. Then drop them heavily by your sides. Sigh three times. Bend over from your waist and hang in that dropped over position while you groan loudly. Really loosen. Uncurl slowly, straighten your body – and then stretch. Jump up and down and let some easy sound come out on an uhh sound. Yawn widely, stretch your tongue out for a moment. Imagine a huge spacious room at the back of your throat. Stay with that image but hum on a strong mmm. Open up onto mmaa. Feel that vibration?’ Janet follows this and after 10 minutes or so she feels looser and less tense, and her voice has lost its held quality. She has not consciously attended to knowledge, awareness or techniques but the actions have changed something. This approach was the one that I observed when I first worked as a voice teacher in a major drama school. The head of voice did very little explanation of the technical or anatomical underpinnings to voice. What she did was to ensure that week after week the students played with body and vocal change, and this change became a part of their ordinary functioning. Both approaches have their place and their limitations. Intellectual analysis and awareness of vocal tract structure and function can inhibit a speaker who is not also given the chance to practically explore how to incorporate a new pattern into both imaginative and emotional

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life. On the other hand, an actor in training with no background in anatomical understanding lacks core knowledge that can be both a tool of protection and a door to further learning. Different people favour different ways of learning, and one of the many rewarding aspects of voice work is that we can choose from either approach at different times and with different clients, ideally adapting to the personality, background and orientation of our client. Nevertheless there are certain principles in common to all voice work, and Chapter 2 looks at these.

Chapter 2

The nature of practical voice work

‘Holistic’ is a word increasingly applied to sell anything from cereal bars to medical practices. The Oxford American Dictionary (McKean 2006) defines it as ‘characterized by comprehension of the parts of something as intimately interconnected and explicable only by reference to the whole’. Practical voice work has to be holistic because we are dealing with a richly complex whole, where personality, cognition, body, spirit, context and imagination connect and eddy in the influences of past and present. Voice practitioner groups generally agree that their work is holistic – combining mind and body. Chapman (2006) makes the word one of the three lynchpins of her singing teaching philosophy. Harrison’s (2006) title includes the phrase ‘exploring a holistic basis for sound teaching and learning’. Linklater (2006) writes of the ‘psychophysiology’ of voice, whereas the Lessac Kinesensic Training course is described as a ‘holistic, comprehensive and creative approach to all aspects of developing the body and voice’. In the clinical literature, Colton and Casper (1996) say ‘the relationship between the person and the voice must be understood and incorporated into the therapy programme’ and the wide-ranging body of papers in Thurman and Welch (2000) goes under the collected title of Bodymind and Voice. This chapter describes seven strands that underlie a philosophy of holistic practical voice work. I think of them as belonging to two different energies, yin and yang. These have their origin in ancient Chinese philosophy and are considered to be two opposing but complementary life forces. Yin is associated with words such as passive, letting happen, process and evolving, whereas yang relates to terms such as action, effort, outwardness and goal direction. • Yin: (1) listening (2) releasing (3) imagination • Yang: (4) practical voice care (5) motivation (6) technical work (7) incorporation.

Voice Work: Art and Science in Changing Voices. Christina Shewell © 2009 Christina Shewell. ISBN: 978-0-470-01992-4

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The concept of these is of shifting levels and strands. They are not a chronology, because we can choose to go in anywhere we like; first one is to the fore and then another, and two or more may work together at the same time.

Listening The German film ‘Into Great Silence’ shows the lives of a group of Carthusian monks in rural France. Almost 3 hours long, with virtually no speech in it, it has been surprisingly popular with audiences of many different countries. In this world of excess sound, stress, pressure and threat, there is often an unrecognised hunger for the deep refreshment of silence and stillness. We use quiet listening skills as we hear a client’s story, watch and sense the emotions that an actor or singer expresses through voice, or attend to the individual sound qualities of a voice. Our clients have to be able to listen to their own sounds and those that exist around them. As Berry (1994) points out ‘the more developed your ear is, the more open you are to the possibilities of what your voice can do’. Often a teacher says ‘try this’, and the client has to focus on the model sound to imitate it, because, in most voice sessions, it is rarely possible to see much happening. If I make a vocal sound and you produce a very similar sound, your vocal muscles and resonators will generally be moving in a similar way to mine, and that is part of what I want to happen. Our sounds lead us to a similar ‘functional anatomy’. Sometimes we have to make that explicit to a client as we make the sounds together.

Voice story: Sophie Sophie was a 23-year-old singer who had developed vocal fold nodules after working for a summer season in a holiday camp. After four sessions of voice therapy she was much improved, with good breath support for her spoken voice and much less throat constriction. I decided to work on vocal fold flexibility in pitch range exercises to encourage the folds to vary in shape, length and tension. The nodules were still present, so Sophie’s pitch glides and high notes were breathy and even cracked at the top. Singers naturally hate to make a ‘bad’ sound, and Sophie was upset that she could not get them as clear as mine. It was important to reassure her about this. I acknowledged that it was hard for her to hear me soar up the scale while she struggled. I explained that, although the top notes were not yet clear, her laryngeal muscles were working to put her folds and vocal tube in the right shapes for those sounds to come later on. I checked that she was not using unhealthy tension, and Sophie could observe how the notes became clearer over several weeks of work.

Practitioners also encourage clients to listen in a different way, by feeling a sensation. Clients need to ‘tune into’ body or breath, or the link between voice and feeling. Inner attention and time are often necessary to become aware of habitual tightening patterns, and how to release unnecessary tension. There does need to be silence for true internal listening, and not everyone is willing to do that.

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Voice story: Adrian I had been working for a couple of sessions with Adrian, a very busy and sociable politician, whose voice regularly became tired and strained towards the end of a day. As he was facing a particularly busy time with an imminent General Election, he came to see me for some voice advice. He told me that he had recently been through a bitter divorce, and said that it was good to ‘throw myself into my work’. We talked about the excess tension that I felt in his neck, shoulder, upper back and throat muscles. Adrian agreed that this area did feel ‘sore and aching’ at times, and we discussed options for managing this, because it was relevant to his pattern of voice tension. As he enjoyed the physical release that he felt in our sessions, I asked if he could have an occasional quiet evening on his own at home, with silent time to rest his voice and his body. He was shocked: ‘My dear!’ he said ‘I don’t believe I’ve spent an evening in on my own for ten years and I certainly don’t want to start now.’

Releasing Clients may need to do active exercises, and they may need to learn how not to do. Voice work has traditionally included the idea of relaxation, and provided that its nature is carefully specified this term may still be useful. But voicing needs healthy tension; the relevant muscles need to be toned and ready for action, and the mind must be alert and ready for communication. An actor or singer in a demanding performance will need a high level of tone in the muscles of the body and mind. ‘Release’ is a more apt term than ‘relax’. The aim is not for an absence of tension but a reduction in excess or inappropriate muscle tension. Then the body and mind are more likely to be in a focused and balanced state for the context, and the voice can be released rather than pushed. Singing teacher Oren Brown (1996) writes ‘it isn’t so much a matter of making sounds as it is a matter of learning how to let sounds happen’. There is no point in starting strong high-energy muscular exercises if you are trying to layer them on top of a speaker’s already over-tight musculoskeletal system. The client needs to be able to experience a change in any unnecessary clenching and holding, before he begins the regular work and practice needed to develop a new habitual muscle pattern. This is one of the reasons why many voice practitioners do some work with clients on the floor, or sitting with their heads supported. The human head weighs around 14 lb/6.4 kg, and when we are upright it is held up by a healthy tone in the neck and upper back muscles. If we identify with our hands that a speaker has a too-tightly held pattern of excess tension in the sternocleidomastoid muscles at the side of her neck, we might want her to experience what a deep general release feels like, with head supported, before we work for a more balanced specific tension pattern. Anyone who exercises regularly knows that excess tension is often released in movement. The choice of stillness or movement work is always available to us. One client may need to stretch and run on the spot to centre the breath and release the shoulder tension, whereas another may need the stillness and support of the semi-supine floor position. A group class

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often needs both. The ability to recognise whether we need to ‘flop or leap’, is part of physical intelligence that helps us manage stress.

Imagination Most clients are helped to incorporate new physical vocal patterns into the ‘deep structure’ of ordinary voice use if they work on the technical aspects and then use that new freedom in imagery, text or improvisation. Linklater (2006) says ‘in the technical work you carve out paths from the mind to chosen muscles; in the imaginative work you know those paths are there and you run along them’. Imaginative exercises help to link body awareness or movement to the unconscious mind and autonomic nervous system. For example, repeated technical work on breath placing may build up new neuromuscular patterns, but may stay divorced from the speaker’s reality. If she is then asked to imagine a situation where she feels frightened or tense, she can observe any tendency to hold her breath or breathe with shallow respiration, and then observe the breath changing as she moves into imagining an utterly reassuring and relaxing experience. For many people, using an image enables them to access a sensation and movement in the body that technical instructions will not achieve. A successful singer told a conference audience ‘when I darken the sound, I’m singing further into the cords’. Although not anatomically possible, the singer knew what she was doing and something changed as she used that image. It is a short cut. In one of my own singing lessons, I struggled to find a particular vocal quality as the teacher accompanied me on the piano. ‘Lift the sound,’ he said, and suddenly there was the quality. Afterwards I analysed what had actually changed; in that instant I had slightly lowered my jaw, widened the space at the back of my mouth, brought my tongue forward and lengthened my neck. But if he had told me to do all these things, I would have stumbled among the words and never have found the coordinated movements needed. He knew what he wanted, and he gave me the image for it to happen. Traditionally the use of active imagination and visualisation has been seen as sitting squarely in the realm of the arts, and speech and language therapists (SLTs) use far fewer image exercises. It is as if there has been a fear of distorting the ‘truth’ of concrete anatomical knowledge. However, there is now a growing body of scientific research into the effect of the imagination on the brain, and into the ways that emotions can affect cells. ‘Imagination’ comes from the Latin word meaning to picture to oneself, and refers to the ability or activity of forming ideas or images of something not present to the senses. It has long been known that specific parts of the brain are activated as we hear, see, touch, taste or smell, but research has found related brain activity in imagined perceptions. There is increasing evidence from the relatively new fields of neuroscience, psychoneuroimmunology and psychoneuroendocrinology about the relevance of emotions and cognition to the health of the body. Harvard University neuroscientists Kosslyn et al (2001) define mental imagery as occurring ‘when perceptual information is accessed from memory, giving rise to the experience of seeing with the mind’s eye or hearing with the mind’s ear’. They say that, although this used to be seen as belonging to philosophy and cognitive psychology, ‘the emergence of cognitive neuroscience has opened a new chapter in the study of imagery’. Reviewing the

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evidence, they report that 90% of the brain regions used when we imagine seeing something are the same as when we actually see it. This is also relevant for other senses. One study asked musically trained individuals to listen to the opening notes of familiar melodies and then to imagine hearing the melody inside their heads. Brain imaging found that, in both real and imaginative listening, the same two particular regions of the right temporal lobe were active. (We might draw the tentative conclusion that this is proof that there is benefit if a singer silently practises her song ‘in her head’.) So, imagining something can activate much the same parts of the brain as actually perceiving it in reality and, as the brain controls the reactions in the body, certain related physiological processes are likely to happen. If you vividly imagine that a large piece of a cut juicy lemon is placed on your tongue, you may find that a sudden rush of saliva is produced. The relevant part of the brain makes your salivary glands act as if you actually taste the sharp juice. There is also evidence that imagination activates physiological processes such as heart rate and breathing in a similar way to a real-life experience. Kosslyn et al say that the therapeutic applications are potentially broad, and describe how several psychological approaches have integrated visualisation as a way of healing. Imagining a positive experience can release endorphins, chemicals made by our bodies that have been found to have effects in making us ‘feel good’, and act as a natural pain killer. Cohen et al (2003) tested the idea that feeling positive is better for the immune system and general health. The emotional states of 334 healthy volunteers were assessed, and they were given a dose of a rhinovirus which causes colds. The researchers found that people who were depressed, nervous or angry were three times as likely to get ill as those who were energetic, happy and relaxed. Even in those who did catch the cold, a positive mood reduced complaints about the symptoms. Linklater (2006) refers to neuroscientist Antonio Damasio’s concept of extended consciousness as she believes it is highly relevant for the actor’s work ‘since imagination is the language of acting’. Imagination is also a language for other vocal change. The continuing neuroscience research provides evidence of the physical links between mind and body, and points to the value and relevance of using imagination in voice work.

Practical voice care Many people have very little knowledge of how their voices work or how to protect them. A student research project posed a number of ‘voice’ questions to travellers at a large London station. It found that several people believed that they had multiple vocal cords, one person picturing that the cords were splayed across the inside of the throat like harp strings. None had any idea how many times the vocal folds vibrate in a second, or how to look after them for healthy movement. Simple care strategies can make a huge difference to the way a singer with a streaming cold copes with the need to perform eight shows a week, to how a client with nodules manages to stay vocally effective, or to the way that a group of acting students learn to look after their voices. We all need to know what advice to give to a singer who is diagnosed with asthma or reflux, or a public speaker whose throat often feels dry when talking, or an actor who complains of morning huskiness after his late nightly consumption of spicy curries and several Irish whiskies. These practical steps are fully described in Chapter 16.

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Motivation Self-help books on voice are stimulating and thought provoking, but as Linklater (2006) says ‘a book is a poor substitute for a class’. Most people who are serious about changing their voices need to do some work in partnership with a voice practitioner. An outside expert can hear, see and touch the sound of speaker or singer, and give the feedback, practical ideas and experiences that enable change to take place. He will also encourage motivation, because of course no one is going to work cooperatively and energetically on voice without a strong enough desire to change and at least some enjoyment of the work. ‘Constructive selling’ is often essential to ensure that the person referred for hospital voice therapy continues to attend. It may also be necessary for the business person who is sent for voice and presentation coaching by his boss, or the performer who feels that she needs no voice teaching as she is already perfect for a particular role. A practitioner usually discovers early in the working relationship how much a particular client’s voice matters to him, and how much work and attention that person is likely to commit to voice change. But using the concept of the coach, it can also be a good idea to ask questions along the lines of: • • • • •

How are you with the idea of regular practice? Are you fairly self-disciplined? How long would you be prepared to practise in a day? What time of day would work best in your busy life? How can I best support you in this: a recorded exercise sequence? Written instructions? One long session of practice on your own or lots of short moments?

Voice practitioners have great individual freedom of choice as to what they will do in a voice session. This is shaped by their own personalities and interests, as well as by those of the client and the context. Some voice therapy clients enjoy using dramatic prose or poetry texts to extend their pitch range, whereas others find such activity deeply embarrassing and much prefer the use of a computer software package where they can see their voices rise and fall on the screen. Some singers love to see their vocal folds in glorious colour as a laryngologist examines them; others are horrified at seeing the wet inside of their bodies. Some actors actively want to understand the anatomy of voice, but others feel that it cramps their creativity and natural voice production. They respond best to the shadows of the imagination, rather than the clear light of concrete pictures. The idea of different learning modalities is an important one in education. Some of us learn predominantly through the auditory sense (we talk to ourselves in our heads), some through the visual modality (we see pictures in our heads when thinking), and others favour the kinaesthetic sense and learn through sensations. We cannot necessarily adapt our teaching to every individual client, but an awareness of these different tendencies can help us to avoid excess rigidity in our approach, and may give us new ideas on how to slant our methods in the best possible way for an individual. It may also sometimes explain why particular exercises do not reach some members of a group class. Parallel to this is the fact that clients can be differently affected by the actual words of our instructions. Perhaps we want a speaker to extend her pitch range by stretching and shortening her vocal folds. She might immediately feel inhibited if asked to ‘sing up on some

The Nature of Practical Voice Work 25

notes’, but will feel much more confident if we use terms such as ‘slide, swoop, step up, or speak up your pitch range’. Although strong criticism may be a necessary part of the teaching of singing and acting students, ‘it is important in teaching people of all ages that they should be encouraged to think not of the mistakes they are making but of building up a new set of habits’ (Thurburn 1939). If a speaker is working on her breath placing and says ‘I’m doing it all wrong’, our response can be reassuring. We might explain that ‘lots of people do it like that and it can work fine for their ordinary conversation, but for your voice development or healing, there are better ways of doing it’. It is important that there is a true respect for the process through which an individual is travelling. Voice work is not about bullying, showing off, gurus or mystification. Sensitivity and spontaneity are essential, since a rigidity of approach will simply not be effective with all clients or in all contexts. A brief explanation of why we are doing something is relevant for many clients, whatever their intellectual ability. It helps give a sense of control to the speaker, and can also lessen any awkwardness that making ‘odd’ sounds can engender. Practitioners may ask clients to make extraordinary noises and, though actors and singers are usually hungry to let their voices extend, others are likely to be more inhibited. Many people have the sense that they should not speak in a loud voice, open their mouths too wide or make odd sounds that do not relate to actual words. Some are embarrassed even to glide up the pitch range on a high eee – an exercise that therapists often request in the clinical atmosphere of a hospital treatment room. If I sense self-consciousness I sometimes lightly point out that, although a physiotherapist can work on a stiff shoulder in dignified silence, we have to make noise in work with a stiff voice. Particular sounds show that particular muscles and tissues are working, and we can explain that: ‘This glide up and down your pitch range actually makes quite a lot happen. It allows your vocal folds to shorten, thin and tighten, and then lengthen and relax, while the larynx rises and falls in your neck, and you coordinate this with strong breath pressure under the vocal folds. All that in one simple sound!’ The concept of ‘play’ is a useful one here and has a double relevance: we may need to create an atmosphere of enjoyable voice-play for our clients, and they need to be willing to play their voices like an instrument. Making those ‘silly’ sounds at the same time as a shy client can help, as it is usually slightly more comfortable to caterwaul with the trainer than it is to produce an embarrassed solo. Unless the client is motivated voice work will not be effective. Ultimately it will always be a person’s choice to work or not, as this unusual story shows.

Voice story: Gillie I was telephoned by a wealthy businessman who said he had finally found the woman he wanted to marry, but that she did not ‘sound right’ for his successful world. It was not a question of accent but of what he called ‘her north London whine’, and he wanted to know if I could do anything about it. It sounded like an enforced version of Shaw’s ‘Pygmalion’ and I was initially repelled by the idea. I asked what Gillie felt about it. He told me that, although annoyed with him, she saw his point and ‘wanted to give it a go’.

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I said that I would only set up a session with Gillie if she herself rang me – which she did. We talked about her feelings and agreed to meet. As she relaxed with me, she began to say that actually she did not like her voice and would be interested to get rid of what she called its ‘tight’ tone. I could hear that she had a noticeable back of throat (pharyngeal) constriction and this was probably tightening her soft palate and holding it down. She had excess nasal resonance, giving the impression of a thin whining tone. Gillie also had a repeated pattern of a falling pitch line in her conversational speech, which made many of her utterances sound slightly complaining. We decided that she would try out a session of voice work, and I made sure that there was lots of opportunity for reassurance and humour in this. In strange duets of sound making, we explored the contrast between chest resonance and nasal resonance qualities, and made our sentences rise and fall in pitch. Because she enjoyed them, Gillie decided that she wanted more sessions and also worked on the exercises and self-monitoring on her own. At our fourth meeting, she met me at the door of their luxurious house saying ‘I’ve got him! He proposed to me!’.

Technical work Vocal technique implies the use of a discipline of learnt skills that safely underpin freedom of expression in any voice quality or energy. As American dancer, Martha Graham (1991), wrote ‘technique is a language that makes strain impossible’. The practitioner leads student or client through a series of physical actions. Voice work is never just muscle work but, when necessary, practitioners should not shy away from the idea of encouraging regular repetitive physical practice. Classically trained singers often do several hours practice each day to develop the muscles, shapes and sounds of their craft. One client said ‘my muscles learn the songs and then I perfect the sound and the emotion’. Voice teachers may emphasise the need for actors to continue regular practical work, but they vary in terms of their commitment to this. Voice therapy may also need periods of frequent muscle work practice. Patterns of muscular behaviour may need to be repeated many times until they are part of ‘implicit’ or ‘body’ memory. In my early years in voice work it seemed that repetition of an exercise was inherently boring, and that I needed to continually find new exercises in order not to bore my clients. In my first drama school post, I watched the experienced voice teacher taking first-term students through essentially the same 20-minute basic sequence at the start of each voice class. The students audibly changed as they gained confidence, strength, flexibility and coordination. Athletes, golfers, tennis players all recognise the need for drills to set up firm neuromuscular links. Indeed, constant innovation in physical exercise can itself be tedious, and its effects can be confusing and diffuse. Repetition of a physical movement or sequence of movements is part of the establishment of that ‘embodied knowledge’ so important in true learning. That intensity of repeated practical work is a core part of the successful Lee Silverman programme (described in Fox et al 2002), which wide research has found to be effective in improving the speech clarity and loudness of people who have Parkinson’s disease. Some speakers need quite rigorous programmes of practical work, which may involve them working in a disciplined way every day for a while, or at least 5 days a week. As they

The Nature of Practical Voice Work 27

repeat an exercise in the session, I sometimes make explicit that voice work ranges from the artistically magical to the brute mechanical, ‘and at this moment you are involved in the brute mechanics, to set up new neuromuscular patterns so they will become automatic’. In Vocal Exercise Physiology Saxon and Schneider (1995) say that both voice teaching and exercise physiology train muscles: ‘the sciences are parallel in nature, and yet the physiological principles involved in the performance of athletes in both fields have not been integrated.’ Schneider et al (1997) write further about this where they consider high-level voice development to be ‘directly related to the level of fitness and conditioning of the performer’. General physical fitness is vital for the performing voice, but is also relevant for non-performers. If we feel weak, unfit and overstretched, our voices are likely to mirror these states. In general, the fitter and stronger our body, the better our voices can sound – potentially at least. But there is no simple cause and effect. In post-match television interviews some tennis and football players speak on quite a monotonous pitch level. They are in the peak of physical fitness, and may have been rushing around a tennis court or football pitch for 3 hours, so why does that not encourage movement in the voice? It may be just because they are so active in their general movements that their voices have no need to flex and move. Berry (1994) says ‘dancers often have poor voices because they give expression to their feelings through another medium’. Body movement is a crucial part of warming up and freeing the voice, but it may need to be the right kind of movement. The principles and practice of physical exercise cannot be rigidly applied to the world of voice work. The process of perfecting a golf club swing is qualitatively different to developing the sensitive, flexible voice that is needed to be an effective preacher, teacher or actor. Brown (1996) says: ‘I have referred to singers as vocal athletes . . . but the muscles of the larynx are miniscule compared to the muscles dancers and divers use.’ Voice is a psychophysical activity; it is not simply a matter of ‘pumping vocal iron’ and we can never completely separate vocal and speech muscle function, the emotions and personality of the speaker, the nature of the words to be used and the context of communication. Schneider et al (1997) believe that improvement of a voice is most linked to specifically targeted and individualised muscle training, and describe five principles recommended by the American College of Sports Medicine to best elicit a training effect: 1. Overload principle: change happens in working muscles with an additional workload. So if we are working to extend a voice, we need to place an extra demand on the vocal muscles, using repetitions and extra effort. This is seen in vocal performer training. 2. Specificity principle: training is most effective if work is directed at the exact muscle groups and neuromuscular movement patterns specific to a particular function. The authors give an example in singing work: to work on reaching and sustaining a high loud pitch, the relevant muscles (cricothyroid and thyroarytenoid) should be strengthened using intense contractions of short duration with lots of frequent practice. But to develop stamina for long voicing, the muscles should be strengthened using less intense contractions for long periods of time. 3. Individuality principle: as discussed in the section on motivation, it is vital to take into account the individual’s needs and capabilities, for no rigid programme can suit all. 4. Reversibility principle: most physiological benefits of training are probably completely lost after 4–8 weeks of inactivity. ‘Use it or lose it.’ If a new neuromuscular pattern has

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been deeply established, this should remain without further specific training, and for most people the act of normal speaking is practice enough. A singer or actor can, however, feel that the voice is ‘rusty’ and that she needs to work hard to bring it back to the high level of competence and control. 5. Length of practice principle: research into exercise progression shows that the greatest physiological improvements in fitness are seen in the first 6–8 weeks of a training programme. The implications of this conclusion are relevant to the findings of Holmberg et al (2007). They assessed the effects of voice therapy with seven female ‘voice fatigue’ clients, and found that most change occurred after the mid-therapy point, i.e. between the fourth and eighth sessions of voice treatment. This is an important finding because four sessions are frequently typical for the number of treatments given to clients with muscle tension-type voice problems, and the study suggests that this may not be adequate for maximum improvement.

Warm-ups The American College of Sports Medicine recommend a warm-up phase before exercise and a cool-down phase at the end. This relates to the performer who is using high intensity voice in a long show. A warm-up increases the blood flow to relevant muscles and their temperature, probably making them more flexible and malleable. Conversely, an exercise ‘cool-down’ with gentle movements helps venous blood flow back to the heart and avoids blood pooling in the muscles that have been working. Amir et al (2005) used acoustic measures to examine the effects of voice warm-up in 20 female singers, and conclude that it has ‘a significant and measurable influence on the vocal quality of young female singers’. Bagnall and McCulloch (2005) found that ‘the judicious increase in exertion had a perceived and measurable beneficial effect on the voice’.

Incorporation Deep voice change takes time. Even when a trained singer can immediately produce a new voice quality, she then has to incorporate it as part of her natural singing style. It is very difficult to sustain a deliberate and conscious change in the way that we speak. Suddenly ‘putting on’ a different voice quality will affect the way that we feel and relate to the world, and sound false to our friends. Rodenburg (1997) writes ‘if a beginner actor works well and willingly, within a year the body, breath and the free and placed voice are set in place’. The ideal is that speaker or singer moves from awareness, through control and practice, into the ability to let go of conscious effort so that the voice can be organic with the speech or music. Sometimes one insight or awareness – ‘Oh! I can feel what my jaw always does when I am nervous!’ – can make a dramatic and speedy difference to long-held habits, Usually, however, integration of new adjustment takes time and regular practice. There are four main types of work that clients can do alone to help to naturalise a new pattern; some speakers need all, and some just one: 1. General self-monitoring awareness, e.g. a client records himself in action, or asks his partner to pick up on the over-use of an umm or throat-clearing habit, or notices his breath as he sits on a train.

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2. Specific general voice care steps agreed in discussion, e.g. a musical theatre performer takes time to release excess tension each day, drinks more water, avoids evenings in noisy smoke-filled rooms, warms up and cools down the voice after a big singing show. 3. Setting aside a deliberate time in a day or a week to work on specific exercises. If we record these for home use, the person has an auditory coaching companion as she practises. Personalised recordings contribute significantly to client ownership of the voice work process. 4. ‘Instants’: these are specifically designed short exercise sequences to be done quickly at socially appropriate moments during the day, e.g. a teacher might do three quick yawn–sighs to release a build-up of throat constriction each time that he goes to the bathroom at work; a call centre operator could shrug her shoulders and stretch her arms above her head every hour or so during a long shift; a singer recovering from surgery for a vocal fold cyst could do 2 minutes of quiet sirens up and down her pitch range every 4 hours or so, to restore flexibility to her vocal folds. Speaking or reading other people’s words aloud in texts is a bridge between exercise and the speaker’s own words, e.g. we may work with a speaker on changing a pattern of hard voice onset. Reading a text that contains many words that begin with a vowel will give her repeated practice in using initial vowels with softer onset; examples are the Towne–Heuer reading passage (Heuer et al 2000), included in Chapter 3, and Turner’s (1950) vowel paragraphs. If we are working to extend a singer’s spoken pitch range, he might read some magazine advertisements with an exaggerated intonation pattern. These are artificial exercises but involve continuous speech. Clients can then be asked to tell back the passage in their own words, still keeping the focus on the task aim. Immediately after that, when the use is still fresh in the mind and muscles, the speaker can be asked to use the new pattern in ordinary conversation. If a text is chosen sensitively for a person or group, it can access a vocal freedom that might not be available in a person’s own words. A public speaker will find previously untapped aspects of his voice in exploration of carefully selected texts from Shakespeare or Eliot. One reserved police inspector with monotonous pitch range found a new musical rise and fall in his voice when asked to read a mock radio news script in the manner of a ‘feisty over-enthusiastic newsreader’. He was then able to modify that rise and fall as he moved into using his own words.

Implicit memory The point of all incorporation work is to ensure that new patterns of vocal behaviour become part of ‘implicit memory’. Katherine Verdolini (1997) has contributed a valuable chapter on the ‘principles of skill acquisition applied to voice training’, which contains research and experience that is highly relevant for voice work. Learning how to do something is part of a set of memory functions called implicit memory, ‘memory without awareness’: ‘Specifically implicit memory is reflected by any performance benefit from prior practice or exposure to stimuli, without learners explicitly remembering those stimuli.’ As we saw in Chapter 1, we can learn with our intellects, but we can also bypass conscious knowledge to learn new patterns of ‘muscle memory’. The body learns, so we do not have to think about it each time. I taught myself to type in a haphazard fashion and

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do not touch type; I would be unable to describe where any particular letter is placed on the keyboard. But, although I look at the keyboard when typing, my fingers have already gone to the right keys because they ‘remember’ where each letter lies. It’s an important concept in working the voice. We want our clients to learn or develop new patterns and powers in their voice use which then become automatic. We do not want a singer to think about consciously releasing her tight jaw and bringing her tongue forward while performing, or an actor to waste emotional energy trying to remember places in a script where he might breathe. We bring a specific voice aspect up into consciousness, work on it a bit to change what is not helpful, and then let it drop back into unconsciousness, where it belongs. As Verdolini says: ‘at best, conscious awareness is irrelevant for implicit memory. At worst, it may interfere with it.’ The main points that Verdolini (1997) concludes are relevant for effective voice skills learning are as follows: • We learn best by sound, sight and touch; voice is a muscle (motor) task, and the client will learn best if he practises with full attention on the accompanying perceptual information, i.e. what he sees, hears and feels in his own body. Berry (1994) illustrates this from the voice teaching perspective when she writes: ‘good speech . . . is you discovering the feeling of making the sounds themselves – it is you becoming muscularly aware of the movements of the tongue, the lips and the palate.’ Intellectual understanding alone is limited in its effectiveness of learning a practical skill, for the ‘verbal instructional mode’ will help a speaker or singer to talk about voice but it will not improve their voice production. Verdolini (1997) writes that, although voice science knowledge may be helpful to us as trainers, it is not necessarily helpful to voice students: ‘mechanistic instructions may be fruitless or even counter productive.’ To give a specific example, let’s imagine that you want to teach a woman with a thin head resonant quality so that she can learn how to use her deeper chest resonant sound. If you ask her to intone a long aaaah, and at the same time say ‘try to release the neck muscles, because the larynx is lowering in the neck, and this creates the space needed in the throat for more resonance in the chest as well’, the client has to spend time and energy to translate the complex verbal instructions into perceptual learning. If instead you let her hear you make a constricted voice and then an open throat voice, let her look at your own good head and neck alignment, and let her feel the vibrations under her hand on her chest as she intones a long aaaah, she will be using the perceptual modality, which will better set up a new implicit memory. In this perceptual exploration, we best learn a new skill if we fully attend to the task, i.e. to the doing rather than the instructions, and have as few distractions as possible. • Implicit memory depends on repetition. Verdolini (1997) quotes the 1890 words of renowned American psychologist William James: ‘Continuity of training is the great means of making the nervous system act infallibly right.’ As has been described, a large part of voice development involves muscles working over and over again to establish new awareness, strength or flexibility. • The context where something is learnt is relevant. Until that new implicit memory pattern is deeply established a client will learn best if all practice is done in the same place. Verdolini (1997) writes of the benefits to acting students if they can work on the stage of a theatre, as opposed to always using a separate studio room where they are never likely

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to perform. So we should ideally do at least some training in the context where we are most likely to use the new skill, e.g. synagogue, theatre or classroom. But once a new trained behaviour is established, in order to maximise generalisation to untrained situations there should be varied practice conditions and materials used. • Skill acquisition requires ‘knowledge of results’, which is information about our performance during training. This needs to be frequent and specific, but not too much. Beginner teachers or therapists too often repeatedly enthuse to a client along the lines of ‘Well done! That was great!’. Although we need to be positive, it is important that the feedback is accurate and specific enough to be useful for the client about his progress. • The final principle for learning skills is that of ‘consistent responding’. If we are trying to change an overall pattern of our voice (as opposed to finding a quality that is right for a character or song) we need to use it consistently in a range of contexts. This is highly relevant when we think about the link between the speaking and singing voice. A tenor may have a habitually tense tongue root pattern during his hours of daily conversational speaking; this will not automatically release just because he is in the concert hall. Verdolini (1997) elegantly summarises her findings as: pay attention to perceptual information in numerous repetitions with various tasks. Before we move into action however, we look at how a voice can be investigated so that the appropriate tasks can be chosen for particular clients.

Part 2

Investigating voices

Voice Work: Art and Science in Changing Voices. Christina Shewell © 2009 Christina Shewell. ISBN: 978-0-470-01992-4

Chapter 3

Seeing voices

‘I see a voice.’ (Nick Bottom in Shakespeare’s A Midsummer Night’s Dream)

The audience usually laughs at Bottom’s words, but, as voice practitioners, we do ‘see’ a voice in terms of the person’s body shape, habitual postures, facial expression, the signs of strain in their neck and other aspects. There are also ways that we can see what is happening ‘inside’ a voice in real time as a person speaks or sings, and the focus of this chapter is on these methods. Medical specialists and speech scientists continue to develop new ways to image aspects of voice, and interested voice practitioners can access their work through relevant study days, conferences and voice journals. This chapter describes the following: • The physical examination of the vocal tract • The way that acoustic analysis can show us acoustic patterns in a voice.

The physical examination of the vocal tract Traditionally the secret places of the nasal cavities, pharynx, larynx and vocal folds have been viewed by doctors with a specialism in diseases of the ear, nose and throat (ENT). Many people do not realise that in most countries a general family doctor (general practitioner or GP) will not use the special viewing instruments needed to look at the larynx, and so the ‘deep throat’ area of larynx and vocal folds usually remains unseen at a routine local medical check. This is why structural problems underlying a voice difficulty can be missed; a GP may prescribe antibiotics for a presumed throat infection, but the voice difficulty might be caused by vocal nodules or acid regurgitation from gastro-oesophageal reflux. Even the best GP may assume that the hoarse voice that a singer develops after a heavy cold is caused by laryngitis, not knowing that forced voice use and extensive coughing have precipitated a small haemorrhage on one vocal fold. As described in Chapter 1, a general doctor may refer the speaker for an ENT examination but anxious speakers or singers can also seek out a private examination. ENT specialists may run clinics on their own, or in constructive partnership with a speech and language therapist (SLT) in a voice clinic.

Voice Work: Art and Science in Changing Voices. Christina Shewell © 2009 Christina Shewell. ISBN: 978-0-470-01992-4

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The voice clinic Although there are no agreed standards for examinations and assessments, the good voice clinic will use the most up-to-date imaging equipment and some sort of acoustic analysis of specific vocal aspects. The core team will be SLT, ENT specialist and nurse, but some voice clinics also have a regular attendance by an osteopath, physiotherapist, singing teacher, voice teacher, psychologist, counsellor or research speech scientist. Watching what happens in the throat and vocal folds when someone speaks or sings is a fascinating experience, and voice clinics are very valuable to both clients and those who work in them. If an external teacher attends with one of his own clients, it can establish a valuable link between clinical and artistic experts and may lead to valuable future collaboration. Although Davies et al (2007) found that only 8 of 42 voice clinics had a singing teacher on the team, many more said that they would like to have regular contact with a singing expert. ENT surgeons have the prime responsibility to examine the larynx and diagnose any voice disorder, but nowadays more and more SLTs are choosing to take the specialist training that enables them to carry out their own detailed throat examinations in parallel or therapy clinics. After years of having to refer a client back to a doctor for a laryngeal check-up, it is very valuable for a working therapist to be able to ‘keep an eye’ on the laryngeal state as therapy progresses, or actually see the effects of a particular exercise on vocal fold function. This enables therapists to consider specific techniques ‘in terms of the physiological function that they address and how they must seek to alter the presenting pathophysiology’ (Casper 1995). SLTs benefit from having as much information as possible about the vocal tract and vocal fold function. Voice clinics often provide more accurate information on laryngeal structure and function than a general ENT clinic, where the doctor may have little special interest or experience with the complexity of voice. Therapist Sue Jones routinely carries out laryngeal examination in her Manchester voice therapy clinic, and in 2003 she compared her own findings with the information given in 60 clients’ original referral letters. In over half of the cases, the referral details were misleading or totally inaccurate. Of the remaining cases, 42% had accurate imaging information but the details given were not adequate for planning therapy. Similar findings were reported by Phillips et al (2005), who concluded that ‘fibreoptic nasendoscopic examination in a busy ENT clinic is not as reliable as videostroboscopic laryngoscopy in a specialist clinic, where more time is available’. Before we look at the nature of these investigations, we look briefly at how the length of the vocal tract can be seen in its entirety, from larynx to lips.

Seeing the length of the vocal tract It is always helpful for any voice practitioner to have at least one image of the vocal tract to show a client, as part of an explanation of structure and function. This may be an actual three-dimensional model of a larynx, and most SLT departments and voice practitioner training courses will have one. Putting the words ‘models of the human larynx’ into an internet search engine produces details of a number of companies who manufacture such representations.

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Two-dimensional images will be found in most books on the medical aspects of voice but it is always helpful if a voice practitioner can draw a diagram of the vocal tract from memory during a session. This can be very simple, but allows a picture to be individually tailored to a client, perhaps labelling exactly where he tends to constrict along the vocal tract, or how his tongue shapes particular sounds. Figure 3.1 is an example of the kind of roughdrawn diagram that can be drawn for clients and you can see that there is no need to be a skilled artist. Ordinary X-rays are of limited use in viewing the vocal tract, but, in the 1980s, the late Dr Frances MacCurtain, SLT and speech scientist, pioneered the use of the X-ray technique of xeroradiography in the voice examination of speakers, singers and voice therapy patients. Her xeroradiographs provided beautifully clear images before it was recognised that the radiation levels were too high for safety, and their use was discontinued (Figure 3.2). The images that remain offer unparalleled pictures of the bony structures, soft tissues and air spaces of nose, mouth, throat and larynx. MacCurtain used the images to take measurements of ‘the supraglottic gestures’ – the changes in the structures and spaces above the vocal folds that occurred as people spoke or sang in different ways. She used these to compare one speaker with another, and the

Nasal and sinus spaces

Soft palate Tongue Epiglottis (closes off entrance to trachea during swallowing) Larynx and vocal folds Tube to stomach (oesophagus) Breathing tube (trachea)

Figure 3.1 Hand-drawn diagram of vocal tract, to draw with a client.

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Oropharynx Back of tongue Hyoid bone False vocal fold True vocal fold

Laryngopharynx

Back of thyroid and cricoid cartilages

Subglottic space Front of trachea

Figure 3.2 Xeroradiograph of the vocal tract at rest, i.e. no voicing. (Reproduced with permission of the Department of Human Communication Science, University College London: from the Frances MacCurtain archive.)

same speaker at different times over the course of voice therapy. The legacy of her work has furthered our understanding of the internal structure of the vocal tract and its movements, and xeroradiographs can be useful in both student teaching and explanation to clients.

Seeing the vocal folds The laryngeal mirror The Spanish singing teacher Manuel Garcia is credited with the first use of a mirror placed at the back of the throat to watch the vocal folds in action. In 1855 he published details of his technique of ‘autolaryngoscopy’ and wrote ‘the manner in which the glottis silently opened and shut, and moved in the act of phonation, filled me with wonder’. (The term glottis refers to the space between the vocal folds.) Many of us still marvel at the complexity and delicacy of the moving vocal folds on endoscopic images. Both Garcia and his colleague, laryngologist Dr Morell MacKenzie, used the mirror in their work – an early example of the collaboration between voice doctor and voice teacher that is now part of the voice practitioner world. The mirror is still used by some laryngologists to look quickly at the vocal folds. It can detect major lumps or lesions but on its own it will not give detailed views of the fine

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functioning of the vocal folds, and can easily miss physical problems much better seen with other methods of visualising. It does not allow any speaker to speak or sing while being examined, because the client’s tongue is protruded as he makes a long eeh sound. Although the vocal fold movements can be seen, there is little detail of the subtlety of vibration, and the distorted voice is not at all his normal voice.

Rigid endoscopy/laryngoscopy In this examination, a solid unbending tube, with a downward pointing light and magnifying lens at its tip, is put into a person’s mouth to point down the throat. It gives an excellent view and image of the vocal folds, but, as with the mirror, it is naturally impossible for the person to speak or sing normally. As the speaker has to push his tongue out as far as possible, the back of mouth structures will not be in their usual position for voicing, and the hyoid bone and larynx itself will be pulled upwards.

Flexible nasendoscopy or transnasal fibreoptic laryngoscopy This uses a thin bendable tube, which consists of a bundle of magnifying glass fibres with a light and small viewing lens at the end. The laryngologist or SLT gently inserts the tube through one of the nostrils, pushing it down so that it curves past the back of the nose and into the pharynx, to rest just above the vocal folds themselves. Flexible nasendoscopy gives a good view of the nasal space, soft palate and other structures of the vocal tract as it passes down. Once positioned over the vocal folds, even with the sensation of ‘something at the back of the throat’, most people can still speak or sing relatively normally, so it can give a good view of the vocal folds in action. Both these forms of ‘endoscopy’ (the use of a tube inserted into the body to view its internal structure and function) can be used on their own, or with a DVD recorder and television monitor, to produce and record moving or still images. The vocal folds of most voice clients will be visualised by using one or all of these three methods described above. If, however, the client cannot tolerate any of these methods or there is any concern about tumour or other serious pathology that cannot be visualised well enough, a fourth method may be needed.

Direct laryngoscopy This can happen only when a person is under a general anaesthetic. The specialist passes a small viewing tube with light source, camera and microscope down the throat to the vocal folds, and can also look at their under-surface. It gives a very clear and lengthy viewing of the structure, but, of course, as the person is unconscious, there is no possibility of seeing the folds move in the action of speaking or singing.

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Figure 3.3 Open vocal folds. (Reproduced with the permission of Mr Tom Harris.)

Figure 3.4 Closed vocal folds. (Reproduced with the permission of Mr Tom Harris.)

Figures 3.3 and 3.4 show the kind of images seen in laryngoscopy; they show the vocal folds in both open and closed positions.

The manner of laryngeal endoscopy Some clients find it impossible to bear the use of the rigid endoscope if the metal tube touches the soft palate or back of the throat, because it can set off an uncontrollable gag reflex; the client coughs and chokes and a view of the vocal folds is usually impossible. Others find the procedure of having a tube inserted through either mouth or nose too emo-

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tionally distressing to tolerate, particularly if they are tense or worried. Although there is no doubt that the gag reflex is more sensitive in some people than others, the manner and skill of the professional inserting the tube, and that of his supporting colleagues, are highly relevant to stress free and successful laryngeal endoscopy, whether rigid or flexible. Although it may be an odd or uncomfortable sensation, if the shape and condition of the nasal cavities are normal, and the procedure is done well, flexible nasendoscopy should not be painful. A local spray anaesthetic can be used to numb the lining of the nostril, and Sell (2007) gives a succinct review of what is best used as a topical anaesthetic, and emphasises that it is certainly best to use these with children. However, as fellow therapist Evans (2007) points out, many clients can tolerate the sensation without any anaesthetic spray, as can voice practitioners motivated to see their vocal folds in action. I have had both rigid and flexible laryngeal endoscopy done several times and would recommend voice practitioners to take any opportunity to see their own vocal folds in action, if offered by a trained ENT or SLT specialist at a conference or clinic visit. As with many ‘invasive’ medical procedures when a foreign object is introduced into part of the body, an examination can be less uncomfortable if the patient can avoid tensing the muscles around that place. In an excellent 1998 series of videos, ‘Assessing dysphonia: the role of video stroboscopy’, Cornut and Bouchayer (respectively phoniatrician and ENT surgeon) write ‘it is noteworthy that the tolerance of the laryngoscope improves during the examination if the patient is able to relax’. I have watched originally quite calm patients experience significant fear and discomfort with an irritable, hurrying examiner, whereas others, initially more nervous, accept a lengthy viewing from a sensitive and reassuring clinician. The training of younger ENT surgeons in these procedures is sometimes lacking in the relevance of client posture and emotional handling, and this is not just for the benefit of the person undergoing the examination, because there will be a better view if the patient is physically relaxed. Cornut and Bouchayer point out that the view into the larynx can be blocked by a lowered epiglottis (the ‘trap-door’ cartilage that closes over the breathing tube to stop food entering). This may be due to individual anatomical shaping, but can also happen if a client is tight with nerves, with a backed tongue position and contracted throat muscles. One client said ‘I felt I was gulping with terror when he stuck that thing down my throat’. If the client has to have a direct laryngoscopy, the diagnosis will inevitably be delayed, so it is clearly best to try to make her comfortable enough to accept other viewing methods. A therapist – and sometimes a voice or singing teacher – may be of help in preparing a nervous client for laryngeal examination by allowing her to discuss fears and reassure her with explanation, diagrams and empathy. On a couple of occasions I have used some simple desensitisation techniques with clients who greatly fear any instrument being placed towards the back of their mouths. In sessions before the examination we have ‘practised’ by placing wooden tongue depressors at progressively further points towards the back of the mouth; in both cases this enabled a new tolerance of the procedure.

Comparison of flexible and rigid scopes In their comprehensive book on the diagnosis and treatment of voice disorders, laryngologist John Rubin and colleagues (2006) provide guidance to the advantages and disadvantages of the use of the laryngeal mirror alone, the rigid laryngoscope and flexible

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nasendoscopy. Studies have explored the differences. Södersten and Lindestad (1992) asked individuals to intone long vowels at different loudness levels, and used both rigid and flexible fibreoptic laryngostroboscopy to compare how the vocal folds closed. When five experienced judges examined the images, they concluded that the vocal folds had more incomplete closure when the rigid laryngoscope was used, and this was especially apparent at soft volume. As the voice got louder, the differences lessened, so the results do suggest that clients being examined with the rigid laryngoscope should be asked to produce a loud vowel sound, to avoid giving the impression that they have a habitual gap between the vocal folds. Sara Harris reports that ‘the rigid laryngoscope gives a better picture than the flexible in good hands; even though there has been considerable improvement in the quality of the nasendoscopes, which do now manage strobe images, the image is not as clear’ (personal communication, 2007). On the other hand, therapist Paul Carding says ‘I think the rigid endoscope might still produce the largest/most magnified image for the surgeons who might be looking to operate on a lesion – but certainly the gap between rigid and flexible has closed considerably . . . in our voice clinics, we use flexible endoscopy for our stroboscopy in most cases and only get the rigid scope out for peculiar/unusual looking lesions’ (personal communication, 2007). The best option is to use both methods routinely with most clients, to combine the benefits.

Stroboscopy It is generally agreed that the best way to visualise the vocal folds in action is to use the flexible laryngoscope with accompanying stroboscopy, and to record the images on a digital camera. The terms videolaryngostroboscopy (VLS) and videolaryngeal endoscopy with stroboscopy (VLE) are both used for this procedure. The vocal folds move far too quickly for their opening and closing to be seen by the naked eye. If the view with rigid or flexible scope is lit by a flashing strobe light synchronised in particular ways with the vibrations of the vocal folds, the movements appear to slow down. (You may have experienced this phenomenon while watching people dancing in the strobe light of a club or party.) As Mathieson (1989) says, stroboscopy gives images that are like snapshots of a sequence of vibrations. The use of stroboscopic imaging to examine the actual movements of the vocal folds closely has been recognised as a valued clinical tool for many years. As long ago as 1991, Woo et al carried out a retrospective study of videostroboscopy in 146 patients and found that using stroboscopy changed the diagnosis in 10% of cases referred by otolaryngologists, and contributed significant information to 27.2% of the cases. In a personal communication (2007), Mathieson says that studies suggest that up to a third of diagnoses are changed when stroboscopy is used. Hess et al (2002) state ‘for more than 100 years this technique has been improved and is today considered to be the most important imaging method for clinical assessment of vocal fold vibration’. Certainly every voice clinic should use stroboscopy as part of the way that they examine the movements of the vocal folds, and improvements in this form of analysis continue to be developed.

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Using laryngeal images with sense and sensitivity There has still been no large-scale study of normal laryngeal appearance and behaviour during voicing, so we do not know how much variation there may be, and sometimes the images show variations in structure and function that may not be relevant to the voice problem. The experienced voice clinic team will match laryngeal appearance, client vocal symptoms and intellectual knowledge to find the most appropriate course of action. Sometimes a significant pathology can even be found, but does not necessarily mean the end of a professional voice career.

Voice story: Morwenna Morwenna was a successful popular music singer who began to experience some periods of voice problems when tired. Her voice would become breathy and weak, and her pitch did not feel ‘as reliable as usual’. An ENT specialist found a small sulcus in one vocal fold. A sulcus is a narrow groove, and can interfere with the sound of the voice, depending on its size and its position in the vocal fold. The surgeon told Morwenna that he would not recommend surgery because this had an uncertain success rate, and that she would almost certainly have significant and incurable problems with her voice for the rest of her life. She was understandably devastated by this news, and came to see me in great distress. We talked through ways that she could continue to best use her voice, and I also said that it was likely that, as she had almost certainly had the sulcus for many years, a recent period of stress and fatigue was probably relevant in ‘tipping the balance’. We worked together to protect and support her voice and she has continued to sing successfully ever since. In the medical world clear images of the inside of the body are usually applauded, but it should be borne in mind that not everyone wants to see his own vocal folds – either live or on a recording. Often the client is given no option in this, but such images can be quite disturbing for those who are shocked by the sudden image of the wet redness of the lining of the throat and pale quavering movements of the vocal folds in action. Many viewers have observed interesting parallels between the internal ‘live’ appearance of the larynx and that of the cervix, viewed along the vagina. Abitbol (2006) describes the similarity of their cells; writing about the ageing female voice, he says: ‘a smear test of the cervix of the uterus indicates an atrophy of the epithelium. The same result is obtained from a smear test of the vocal folds: the parallelism is amazing.’ Many clients, however, love to see their voice in action, and to have a photograph from that examination. Opera singer Lesley Garrett developed a vocal fold haemorrhage while performing as Jenny in Kurt Weill’s ‘The Rise and Fall of the City of Mahogany’. In a later newspaper interview, she said that seeing her throat at a laryngology examination had a powerful positive effect, because, although she had spent many years working to master her vocal instrument, she had never actually seen the core structure of her voice. She found the photograph of her healthy vocal folds to be a real confidence booster, and kept it on her wall.

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The handling of the discussion after a laryngeal examination is also important, so that information is phrased in a way that is truly user friendly. The final book of priest and writer Michael Mayne (2006) described his experience of the last part of his life as he lived and died with oral cancer; in it his wife Alison wrote: ‘What is accepted as routine and obvious in the medical world needs spelling out for us in layman’s language so that we can be involved and aware.’

Acoustic patterns The nature of acoustics Speech science is a fascinating and ever-expanding field. As a result of research and development, computer software programs can now offer analysis and visual feedback tools for many aspects of speech and voice, and many SLTs use these in their voice therapy work. As Baken and Orlikoff (2000) state: ‘every clinician can have, in a square meter of clinic space, a laboratory as powerful as any that existed 40 years ago.’ The focus of that voice laboratory will be the acoustics of speech. The term ‘acoustics’ has both a scientific and a general currency. Speech scientist Adrian Fourcin writes ‘originally the word was used in relation to hearing and perception, and this usage has continued to the present day in, for example, the “acoustic nerve” in hearing and in describing the “acoustic” of a concert hall. In relation to speech science, the word acoustics refers to the physical properties of sound’ (personal communication, 2007). Acoustic analysis gives us a way to see the physical properties of sound. It is a highly specialised area, and I would recommend interested practitioners to read Baken and Orlikoff’s (2000) comprehensive Clinical Measurement of Speech and Voice. There are many hardware and software package options available for acoustic analysis, and at most voice conferences different companies offer opportunities for ‘hands-on’ exploration of visual displays of voice. This section offers a brief introduction to why such tools can be useful to voice practitioners, and demonstrates some acoustic visual images of my own voice in action, using one unique analysis system – Laryngograph Speech Studio.

Acoustic analysis and the voice practitioner As acoustics involves measurement, research papers will always contain scientific facts, figures and tables, and many voice practitioners may feel that such papers ‘go over their heads’. As someone more naturally at home with arts-based accounts than research papers, I share this challenge, but know that many acoustic-related findings are relevant to practical voice work. Even the introductory abstract can offer valuable ‘nuggets’ of new knowledge that can be very useful to arts-based voice practitioners as well as therapists. Although auditory perceptual voice analysis is a prime tool in my own work, sometimes acoustic analysis can detect aspects of voice that the ear cannot, and indeed the ear can be mistaken. Listening may not give ‘a conscious awareness of the acoustic details that have combined to produce a given perception’ (Baken and Orlikoff 2000). This can have

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implications for voice work decisions. The medical specialist who mistakes a singer’s resonance imbalance for a disturbance of pitch is one such example of auditory misunderstanding. A singing teacher may decide singer A is louder than singer B because he has a higher decibel level, and work on the latter’s breath support. But acoustic analysis may prove that their decibel levels are the same; the carrying power is due to the fact that A’s vocal folds have a longer closed phase than speaker B, and effective voice work should focus on B’s phonation quality. A voice teacher or therapist may assume a speaker’s excessive nasal resonance is caused by weak soft palate action. Refined acoustic analysis might show that what is actually happening is that the speaker has a problem coordinating the timing of his soft palate movement with speech sounds, or has weak oral friction on sounds such as [s] or [f]. Both these patterns can create an auditory quality of excess nasal tone, but in neither case would simple ‘energetic soft palate’ closure exercises be effective. In the clinical world, acoustic analysis can reveal negative changes in a voice before they are noticed perceptually, i.e. the measurements pick up subtle warning changes before our ears do. Rubin et al (2003) and Speyer et al (2004) report on the significant differences found in the acoustic analysis of normal and dysphonic voices. As acoustic visual displays show a client what his voice is doing, they can offer a useful adjunct to the traditional hearing and feeling methods of voice feedback. For example, a transgender client may be recorded chatting normally about a conversational topic, and software analysis can immediately measure and show her average pitch and pitch range. The client can practise changing this, adjusting her voice to what she sees on the screen. Children can play especially designed games where different aspects of their voice can ‘make things happen’ on the screen – visual voice play as vocal exercise for change. Later chapters describe how the use of carefully selected acoustic software was found to be helpful in the training of both singing students (Welch et al 2005) and in acting students (Laukkanen et al 2004).

Visual displays of voice using Laryngograph Speech Studio Developed by Professor Adrian Fourcin and colleagues at University College London and Laryngograph Ltd, the electrolaryngograph offers direct non-invasive sensing of vocal fold contact by the use of two electrodes placed on the skin at each side of the larynx. (The basic approach is also referred to as electroglottography.) This provides accurate pitchrelated measurement, and a direct way to interpret important links between vocal fold vibration and perceived pitch, voice quality and loudness. Laryngograph Speech Studio is a software and hardware package that enables analysis of both sustained sounds and running speech. As it can be used on a suitable laptop computer to measure aspects of ‘real-life’ voice in ordinary speaking, it provides a portable, powerful and ‘user-friendly’ tool for any voice practitioner and the resulting visual feedback offers much to voice work. Laryngograph Speech Studio was used to analyse a number of extracts of my own voice, and six examples are given in Figures 3.5–3.10; the voice extracts to which they relate can be found on the website audio file. They are included to give a brief idea of how acoustic analysis can enable us to ‘see’ certain aspects of voice.

46 Voice Work: Art and Science in Changing Voices

Speech trace

Lx trace

Acoustic pressure – output from microphone

Vocal fold vibrations, from laryngograph (Lx)

(a)

Speech trace

Lx trace

Acoustic pressure – output from microphone

Vocal fold vibrations, from laryngograph (Lx)

(b) Figure 3.5 Constricted phonation quality (upper box) and unconstricted, rather breathy phonation quality: on author’s sustained vowel. (a) The vocal fold vibrations when the vowel is produced with excessive laryngeal tension. Here the vocal fold closure (closed phase) lasts for nearly 75% of the total duration of each successive cycle. A long closed phase is needed for ‘strong projected’ voice quality, but we need to produce this without the excessive constriction heard in this sample. (b) The pair of waveforms shows the vowel produced with much less constriction in the larynx setting; the vocal folds are open for longer (a longer open phase) in each cycle, and we can hear that as breathy quality. (Figures 3.5–3.10 are reproduced with the permission of Adrian Fourcin and Evelyn Abberton and I am most grateful for their invaluable contribution to the section. Thanks also go to Steve Nevard for enabling the recordings to be made in the specialist environment of the anechoic chamber of the Phonetics and Linguistics Department of University College London.)

Seeing Voices

Speech trace

Lx trace  

47

Acoustic pressure – from microphone Vocal fold vibrations, from electrolaryngograph (Lx)  

Figure 3.6 Creaky voice on author’s sustained vowel [ɑ]. In the upper waveform of this pair, we can see that, from cycle to cycle, the waveform is not exactly repetitive. It is this lack of similarity between adjacent vocal fold cycles that is linked to our auditory perceptions such as hoarse, rough or creaky voice quality. In the lower line, we can see that irregularity in the Lx waveform. From cycle to cycle there are differences in the shape of the waveform, with alternate large and small closures, and irregular times between the components of the cycle.

Speech trace

Acoustic pressure – from microphone

Lx trace

Vocal fold vibrations, from electrolaryngograph (Lx)

(a)

Speech trace

Acoustic pressure – from microphone

Lx trace

Vocal fold vibrations, from electrolaryngograph (Lx)

(b) Figure 3.7 Two types of breathy voice quality on author’s sustained vowel [ɑ]. When we produce breathy voice we may do this in one of two ways: (a) the vocal folds approach each other and vibrate as they ‘wave in the breeze’ of the outgoing air. They disturb that air, and create rhythmic vibrations but they do not actually make contact with each other – there is no closure. (b) The vocal folds are very briefly in contact for a short part of their cycle – a very short closed phase, and long open phase, so there is lots of ‘breathy escape’. In whisper, there is no voice; the vocal folds stay open and do not vibrate. We tense the folds, narrow the glottis and force air between the folds. A friction sound is created, which we then shape into words by altering our vocal tract. Whisper can have high laryngeal tension, or be quiet and relaxed. If we produce moderate vocal tract tension with markedly forward resonance we may produce a good stage whisper.

48 Voice Work: Art and Science in Changing Voices

In Figures 3.5–3.7 the top line in each box shows the output from a microphone, which picks up the speech acoustic pressure changes at a distance of 10 cm from the mouth. The lower line shows the vocal fold vibrations as detected by the two small laryngograph electrodes, placed at either side of the larynx. The upward movements (as seen in direction of arrows) correspond to the closure of the vocal folds; the folds stay closed for a short or longer time, and then peel open. So the bottom of each curve represents the time when the folds are open.

[i] 

Figure 3.8 Sustained [i] and [ɑ] vowels at a steady pitch. ‘Pitch’ is shown by the vertical height of the trace; these two vowels are intoned at a frequency of 203 Hz. Note how well the pitch is sustained for both vowels – a steady horizontal trace – until the breath ‘runs out’. Loudness is represented by the thickness of the trace – so [ɑ] is louder than [i]. Time goes from left to right. The two plots show that there is creak (irregular vocal fold vibration) indicated by the broken line at the very end of each vowel. This happens as the subglottic air pressure drops and it is harder to sustain the steady regular vocal fold vibrations. The broken bit in the middle of the lower right plot is a short burst of vibrato; you can see a vestige of vibrato in the figure for [i].

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(a)

How

are

you

Lulu?

Why

were

you

away?

(b) Figure 3.9 Narrow pitch range and wide pitch range. In contrast to Figure 3.8, the traces show a voice moving up and down in pitch. (a) The sentence spoken with a very narrow variation in pitch. (a) A very wide pitch range. As in Figure 3.8, the thickness of the line relates to the amount of loudness (the amplitude of vocal fold vibration). In (a), ‘away’ is spoken loudly, but is much quieter in (b).

50 Voice Work: Art and Science in Changing Voices

Figure 3.10 Spectrogram for the ‘resonating ladder’ exercise (see Chapter 22). Time goes from left to right. This image shows a sustained vowel that is kept at a constant pitch, but its resonant quality (timbre) changes, so that some listeners will hear it as ‘sounding deeper’. The voice moves progressively from head resonant quality (on the left) to chest resonant quality (on the right), and the vowel quality changes from a front raised tongue setting to a backed lowered setting. Each narrow vertical line represents one vocal fold vibration; you will see that the darkness and width of the horizontal ‘bands’ change over the time of the vowel intoning. These relate to the formants of the vowel – particular areas of strong resonance.

Chapter 4

Hearing voices

Strangers who meet a voice practitioner sometimes make a comment such as ‘I’ll have to watch how I talk now– what do you think of my voice?’. Even if we are willing to do an instant analysis, it takes an act of will to focus on the way that something is said rather than the content, and that concentrated listening usually belongs in a voice session. Most therapists are likely to agree that ‘the clinically well trained ear will always be the primary and most important means of analysis’ (Hammarberg et al 1980). If we substitute the word ‘professionally’ for ‘clinically’, the statement runs true for voice and singing teachers; active listening is a prime tool of their trade. The effectiveness of our voice work is judged by the singers and actors themselves and by their audiences. It is the same with voice therapy. ‘Perception of a person’s voice is at the heart of evaluating and working with patients with voice disorders. Patients and their families decide whether treatment has been successful based largely on whether the speaker sounds better’ (Gerratt et al 1993). The focus of this chapter is on what we hear from a client’s words, and how focussed listening can help us to ‘unpick’ what is going in a voice.

The client’s own words I always make a note of the exact words that a client uses to describe his voice, because they give a clear idea of how much a voice issue is affecting his life and offer significant clues about vocal function.

Voice story: Michael Michael was 16 when he had a severe head injury from a motorcycle accident. Although he had some memory problems when I met him (aged 19), he had made a good physical and intellectual recovery, and was studying horticulture. He had slightly slurred speech and excess nasal resonance, described his voice as ‘hollow, boring and stupid’, and felt that the sound was unattractive to the girls he was longing to know. ‘Hollow’ gave a

Voice Work: Art and Science in Changing Voices. Christina Shewell © 2009 Christina Shewell. ISBN: 978-0-470-01992-4

52 Voice Work: Art and Science in Changing Voices

clue that Michael heard his voice as having the wrong resonance, and he said it was like ‘an echo in an empty space’. It was likely that his soft palate was not working well enough to cut off the nasal escape in much of his speaking. He had a narrow pitch range and a monotonous repetitive pattern of his sentences ‘tailing away’. This gave the impression of lack of energy and interest – the ‘boring’ quality. That word ‘stupid’ clearly illustrated how much his voice was affecting his self-esteem.

When we explain to the client what is creating the voice qualities and sensations that he describes in his own words, we offer him a conscious understanding that can give him a new sense of control. Then we can discuss the action that can be taken to change things.

Informal client rating scales for voice disorder work Measurements and comparisons are vital for health-care, evidence-based practice, and many medical self-rating scales may ask clients to make numerical judgements about aspects of health, pain and functioning. The use of a number can clarify things for an outsider: the stoic who tells the doctor that the pain is ‘not too good’ may feel freer to rate that pain as 8 on a 1–10 scale (where 1 represents a pain-free level where you can do anything you like and 10 is the worst agony that you can imagine). Speech and language therapists usually ask a client with a voice disorder to complete a questionnaire exploring the relevance of the voice problem to her life. Rating symptoms offers a chance to reflect on the detail of voice use and problems, and the therapist can use it to pick up particular issues. The questionnaire will be kept on file for record keeping and report writing, and can be compared with later assessments; it is encouraging for client and therapist to see progress. Many therapists use both a standard version and an informal scale of their own design. The form in Figure 4.1 is an example, designed in collaboration with my colleague, Morwenna White-Thomson, at Southmead Hospital, Bristol. Although it gives an instant picture of how a speaker or singer is feeling about her voice, self-ratings may not accord with the practitioner’s impression. We may hear the voice of an anxious client as mildly impaired, but she may rate her voice at a grade 5 concern level. Another speaker may rate his noticeably strained voice as 80–99% normal and tell us that he is unworried about it.

Client self-rating for other practitioners Self-rating numerical scales are much less used by other voice practitioners. Although simple student self-rating forms can give insights into training effects, the description of a singing or acting voice generally needs the subtlety of words rather than numbers to capture its qualities. Rating scales are useful in work with public speakers, because an instant ‘snapshot’ can be discussed by trainer and speaker, or conveyed to a third party if necessary. The consistent

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A QUESTIONNAIRE ABOUT YOUR VOICE NAME____________________________ DATE_______________________ 1 VOICE QUALITY If 100% represents your fully normal voice, how would you rate your current voice quality? NORMAL

0

1

100%

2

3

60−80%

80−99%

4

40−60%

5

20−40%

ABNORMAL

0−20%

2 VOICE PROBLEM − EFFECT ON LIFE How significantly does your voice/throat problem affect your life ? NO EFFECT

0

1

2

3

4

5 VERY SIGNIFICANT EFFECT

3 CONCERN ABOUT VOICE PROBLEM How much does your voice worry you ? NOT AT ALL

0

1

2

3

4

5

DRASTICALLY

4 THROAT DISCOMFORT Do you have any throat discomfort ? NO DISCOMFORT

0

1

2

3

4

5 SEVERE DISCOMFORT

TOTAL VOICE SCORE

/20

Figure 4.1 Client with voice disorder: informal self-rating.

use of such forms can even provide evidence of effective training for a prospective business contract: ‘We trained 94 clients in voice and personal impact last year and, as you can see from a summary of our tailor-made assessments, that 95% rated their progress as significant!’ Chapter 28 includes a self-rating scale developed for use in the business world. As with pain, numbers sometimes feel safer than descriptive words when starting to talk about feelings. I often ask new clients to imagine a 1–10 scale of habitual physical and emotional tension levels, where 1 represents their most relaxed and unworried state, and 10 is the most anxious and tense level that they can imagine. I say: ‘In your ordinary life, at what number would you place yourself, on average?’ It can provide surprises; the calm teacher rates herself at level 9, whereas the fidgeting, tight-jawed lawyer insists that he is never more than a 3. This simple self-rating is part of the Voice Skills Perceptual Profile.

54 Voice Work: Art and Science in Changing Voices

Formal symptom questionnaires In clinical work around the world, some formal scales have been tested on a large number of patients, and found to have strong reliability and validity; they are an important tool in any research looking at the effectiveness of a particular therapy. One of the most widely used is the Voice Handicap Index (VHI – Figure 4.2). This was developed in the USA, and

THE VOICE HANDICAP INDEX Copyright 1997 by American Speech-Language-Hearing Association. All rights reserved. NEVER 0

ALMOST NEVER 1

SOMETIMES

ALMOST ALWAYS

ALWAYS

2

3

4

F1. My voice makes it difficult for people to hear me. P2. I run out of air when I talk. F3. People have difficulty understanding me in a noisy room. P4. The sound of my voice varies throughout the day. F5. My family has difficulty hearing me when I call them throughout the house. F6. I use the phone less often than I would like. E7. I’m tense when talking with others because of my voice. F8. I tend to avoid groups of people because of my voice. E9. People seem irritated with my voice. P10. People ask What’s wrong with your voice? F11. I speak with friends, neighbours or relatives less often because of my voice. F12. People ask me to repeat myself when speaking face to face. P13. My voice souds creaky and dry. P14. I feel as though I have to strain to produce voice. Figure 4.2 The Voice Handicap Index. (Reproduced with permission from Jacobson et al 1997.)

Hearing Voices

NEVER

ALMOST NEVER

0

SOMETIMES

ALMOST ALWAYS

ALWAYS

2

3

4

1

55

E15. I find other people don’t understand my voice problem. F16. My voice difficulties restrict my personal and social life. P17. The clarity of my voice is unpredictable.

P18. I try to change my voice to sound different. F19. I feel left out of conversations because of my voice. P20. I use a great deal of effort to speak. P21. My voice is worse in the evening. F22. My voice problem causes me to lose income. E23. My voice problem upsets me. E24. I am less out-going because of my voice problem. E25. My voice makes me feel handicapped. P26. My voice gives out on me in the middle of speaking. E27. I feel annoyed when people ask me to repeat. E28. I feel embarrassed when people ask me to repeat. E29. My voice makes me feel incompetent. E30. I’m ashamed of my voice problem. P scale:

F scale:

E scale:

TOTAL:

Please circle the number that matches how you feel your voice is today. Normal 1

Mild 2

Moderate 3

4

5

Severe 6

7

Instructions: These are statements that many people have used to describe their voices and the effects of their voices on their livers. Check the response that indicates how frequently you have the same experience. Never = 0 points; Almost never = 1 points; Sometimes = 2 points; Almost always = 3 points; Always = 4 points. Figure 4.2 Continued.

56 Voice Work: Art and Science in Changing Voices

offers valuable insights into the severity and nature of the effects of the voice disorder on a person’s life. As Figure 4.2 shows, the VHI is composed of 30 statements. The client chooses one of five possible responses about how frequently the statement applies to his life, and these are scored from 0 to 4. A total VHI score can then be produced, giving a range of 0–120. High totals have been found to give a reliable indication of a significant level of disability due to the voice problem. The P, F and E scales refer to the fact that each statement relates to a functional, physical or emotional effect that the voice may have. The assessor can add the points up for each of these to see which is of most concern to the speaker. In the UK, the Voice Impact Profile can be used with both abnormal and normal voice, and its originators, SLTs Stephanie Martin and Myra Lockhart, report that some voice and singing teachers use it with students. Published in 2005, its short 10-section questionnaire investigates the impact of a number of factors on the voice and person. The sections include general health, vocal history and health, voice care, social functioning, the demands on the voice and environmental factors. It also incorporates a voice geneogram, which looks at influences on the voice from an individual’s upbringing and background. Clients’ responses are recorded in a series of columns, forming a histogram, to give both client and practitioner a clear visual picture of the voice-related issues. Martin and Lockhart write: ‘The VIP is not a severity scale, its purpose is to provide a personal vocal profile through the medium of a visual presentation’ (personal communication, 2007).

Specific listening First impressions The words that ordinary people use to describe the voices of others are many and varied and, like the description of wine, often use sensation and emotion vocabulary. Taste judgements differ greatly in both. My glass of wine may taste ‘pleasantly dry with a lovely sunshine quality’, but you find it ‘gritty, sour and unpleasantly rough’. One film critic finds film actor Melanie Griffith’s voice to be irritatingly ‘little girlish’, whereas another writes of ‘the breathy, rich and yet uncertain tone of Melanie Griffith’s voice, which makes her sound as if she’s been around the track too many times and yet is still able to believe in love’ (Ebert 1988). When listeners cannot see the person who is speaking, they sometimes feel that they have a clear image of how the speaker looks, but this is rarely accurate. One of the largest perceptual voice experiments ever done took place in 1927, when radio was the prime form of home entertainment. British listeners were invited to match eight voices (reading an extract from Pickwick Papers) to photographs in the Radio Times. They were also asked to make simple judgements of age, occupation, birth and home locality and whether or not the person was ‘accustomed to lead others’; 4000 reports were sent and ‘the consistency of errors in the replies concerning occupation was as interesting as the consistency of correct judgements’ (Pear 1931). We may well have an immediate sensory or emotional reaction to a voice, but the voice practitioner’s task is to translate emotional impression into physical understanding for appropriate action. After any instinctive reaction, we need to ask: ‘Why does this grating

Hearing Voices

57

horrible voice make me want to run a mile? Ah – it’s that extreme vocal fold roughness, mixed with the monotony of pitch range, excess nasal resonance tone and a consistently loud level. I know what needs to be done now.’

Voice story: a preacher I was asked to see a 47-year-old preacher who was experiencing periods of voice fatigue and hoarseness. He brought with him a recording of a recent sermon that he had given, and I was interested to observe my immediate subjective reaction that his voice was ‘dull and patronising’. I realised that these adjectives pointed to two aspects of vocal misuse that were contributing to his voice problems: • He had a pattern of considerable excess jaw tension, with little movement of the jaw, lips and tongue. This was causing considerable laryngeal tension and there was little variety of pitch or volume. • He regularly spoke with a falling intonation line, ending in a creak as he ran out of breath on longer sentences. This pattern conveyed a feeling that he was ‘speaking down’ to his listeners as the energy dropped with each thought. Sir Arthur Conan Doyle’s great fictional detective, Sherlock Holmes, tells Watson ‘observation shows me that you have been to the Wigmore Street post office this morning, but deduction lets me know that while there, you dispatched a telegram’. Working out what is happening in a voice from its sound is a kind of detective work; we observe the voice and the activity of perceptual analysis helps us to deduce why something sounds as it does.

Formal perceptual voice analysis Although speech scientists Baken and Orlikoff (2000) write that ‘a clinician’s perceptions cannot provide the sole and universal basis [my italics] for mapping and guiding the course of the therapeutic enterprise’, they also confirm that ‘there is as yet no instrument, no technique, no computer, that can begin to match the human auditory system for detecting acoustic variations, or for determining whether they reflect a variety of normal speech or something amiss in the speech system’. In formal perceptual voice analysis, we use an organised and tested listening tool to define and refine those ‘auditory system’ strategies. Analysis is defined as ‘a resolving or separating a thing into its elements or component parts: the tracing of things to their source, and so discovering the general principles underlying general phenomena’ (Geddie 1971). This ability to see things as separate, while still holding the awareness of the whole, is a vital skill in understanding a complex phenomenon such as voice – particularly if we want to interact with that phenomenon. Being able to name the component parts of a large phenomenon allows us to notice things that we might otherwise miss. If we listen with an acute focus on one aspect of a voice, followed by another, and then another, we will be able to hear what is happening in those separate details of the whole voice. In teaching, I often use a mixed metaphor and liken it to shining a beam of light out of our ears on to individual qualities of a voice.

58 Voice Work: Art and Science in Changing Voices

Assessment implies an estimation of the magnitude or quality of something. Our focused listening may identify that a speaker has little tongue movement as he speaks, and we can then specify whether that is slight, moderate or significant. If we place numerical scores on this and agree their reference with other similar professionals, we are developing an assessment. Assessments usually involve numbers, which we can note onto a form or protocol to create a profile of a speaker’s voice. A perceptual assessment scheme can never be considered to be as scientifically objective as an instrumental measure, because the listener’s ears are subjective in what they decide they are hearing. However, there can be a carefully controlled subjectivity, if terms and judgements are tightly defined and judges are trained to achieve as high an agreement as possible. The linguist R.H. Robins (1971) described the three canons of linguistic science as ‘exhaustiveness, economy and consistency’, and these principles apply to any perceptual voice scheme. When we describe any language or voice data in a systematic way, we need to be exhaustive – to attend to all the relevant material that we hear. In addition, our findings should be described in a way that is as economical and consistent as possible, with no statements contradicting each other. Formal analysis and assessment are an essential part of evaluating voice therapy and, although not necessary for most singing and voice teachers, it is a vital tool when proof of change is sometimes required in arts-based voice training. There are five main steps: 1. We record data (speech samples) on a good quality device. 2. We listen acutely to what we hear, using defined parameters, and assign some sort of numerical rating to each. 3. We organise what we hear onto an assessment form (protocol), which may be on paper or on a computer. 4. We analyse and summarise what we find. 5. We interpret those findings so that we have conclusions to guide our understanding of that voice, and this may lead to related action choices.

The data The data are the voice material that we are going to analyse, and for ordinary perceptual analysis a sample should be around 4 minutes. This is usually a recording made as the client speaks conversationally and reads a short passage, but it can be client-specific material, such as an actor’s audition speech, a business presentation or a singer in full vocal flow. It is important to try to get a representative sample of the person talking in as ‘real’ a way as possible. Questions such as ‘tell me how you got here’ or ‘tell me what you had for breakfast’ are not going to elicit natural speech. While setting up the recording, I usually chat cheerfully about the unnaturalness of the situation, and lead into a general discussion about voice work; both are designed to relax the speaker into genuine talk. When appropriate I ask the client to tell me the story of why she is with me, and what she hopes to get from the session. Usually I ask a few interested questions in the first few minutes of this, so that it feels like a real conversation, but, once the person is in full flow, I just use nonverbal encouragement for her to go on talking. This usually elicits a reasonably long stretch of monologue for later analysis.

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59

If the speaker has any problems with reading or speaks a different language, the reading aspect is skipped. Some practitioners argue that, as most people are working on their ordinary spoken voice, it is not necessary to use a reading passage, and indeed people may even put on a special ‘reading’ voice. The choice is yours, but if you regularly use a particular passage, after a while you will virtually know this so well that words and meaning do not distract concentration from the sound of the voice. In clinical work, there are several regularly used pieces. I usually use the following. ‘Arthur the Rat’ reading passage There was once a young rat named Arthur who would never take the trouble to make up his mind. Whenever his friends asked him if he would like to go out with them, he would only say that he didn’t know. He wouldn’t say ‘yes’, and he wouldn’t say ‘no’. He could never learn to make a choice. His Aunt Helen told him that no one would ever care for him if he carried on like this, and that he had no more mind than a blade of grass. Arthur looked wise but said nothing. One rainy day the rats heard a great noise in the loft where they lived. The pine rafters were all rotten and, at last, one of the joists had given way and fallen to the ground. The walls shook and the rats’ hair stood on end with fear and horror. The old rat that was chief said that this wouldn’t do, and he would send out scouts to search for a new home. Three hours later the seven scouts came back and said that they’d found a new house which was just what they wanted. There was room and good food for them all. There was a kindly horse named Nelly, a cow, a calf and a garden with an elm tree. Just then the old rat caught sight of Arthur and asked if he was coming with them. Arthur sighed and said that he didn’t know and that the roof might not come down just yet. The old rat said angrily that they couldn’t wait all day for him to make up his mind, and told the other rats to get marching. And they went off. Arthur stood and watched the other rats hurry away. The idea of an immediate decision was too much for him. He thought he would go back to his hole for a bit, just to make up his mind. That night there was a great crash that shook the earth and down came the whole roof. Next day some men rode up and looked at the ruins. One of them moved a board and under it they saw a young rat lying on his side, quite dead, half in and half out of his hole.

Phonetician Dr Evelyn Abberton has removed all direct speech from the version of this passage that is traditionally used by SLTs. This prevents the more dramatically inclined readers ‘putting on’ different voices, which can confuse the picture of the habitual reading voice. She points out the difficulty of finding a passage that is ‘phonetically balanced’ – containing the same proportion of sonorants (vowels, nasals and /w/ /r/ /l/ and /j/) and obstruents (most consonants) that occur in the language. Arthur the Rat is long enough but The North Wind and the Sun (see below) is too short. ‘It seems that providing you have a passage of around 2 minutes you get the right numbers of the various sound types that are typical of the language; but you don’t necessarily get the full range of sound sequences, like clusters’ (Abberton, personal communication, 2006). ‘The North Wind and the Sun’ reading passage The North Wind and the Sun were disputing which was the stronger, when a traveller came along wrapped in a warm cloak. They agreed that the one who first succeeded in making the traveller take his cloak off should be considered stronger than the other. Then the North Wind blew as hard as he could, but the more he blew the more closely did the traveller fold his cloak around him; and at last the North Wind gave up the attempt. Then the Sun shined out warmly, and immediately the traveller took off his cloak. And so the North Wind was obliged to confess that the Sun was the stronger of the two.

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Material can be designed to explore particular aspects, so the ability to coordinate breath and spoken voice could be examined in sentences of increasing length (see the example at the end of Chapter 19). In the first four paragraphs of the Towne–Heuer Reading Passage (Heuer et al 2000) there are exactly 100 words that begin with vowels. The listener can focus on these words in a recording to find out the number of times the reader has used hard (glottal) onset on these vowels, and this can be expressed as an exact percentage. The authors found a clear difference in the amount of hard glottal attack in normal voices as contrasted with those diagnosed with vocal abuse–misuse, and the passage provides a valuable ‘checking’ tool for practitioners who think that they hear regular hard attack in a client’s voice. The Towne–Heuer Reading Passage (Modified version for use in the UK reproduced by permission of Reinhardt J. Heuer) If I take a trip this August I will probably go to Austria. Or I could go to Italy. All of the places of Europe are easy to get to by air, rail, ship or auto. Everybody I have talked to says he would like to go to Europe also. Every year there are varieties of festivals or fairs at a lot of places. All sorts of activities, such as, foods to eat, sights to see occur. Oh, I love to eat ices seated outdoors! All of the cities of Europe are very beautiful, as are the cities of the U.S.A. It is said that that is true especially for Paris. Aid is easy to get because the officials are helpful. Aid is always available if troubles arise. It helps to have with you a list of offices or officials to call if you do require aid. If you are lost you will always be helped to locate your route or hotel. The local police will assist you, if they are able to speak as you do. Otherwise, a phrase book is useful. I have had to have help of this sort each trip abroad. However, it was always easy to locate. Happily, I hope, less help will be required this trip. Last trip every hotel was occupied. I had to ask everywhere for flats. Two earlier trips were hard because of heat or lack of heat at hotels. On second thoughts, I may want to travel in autumn instead of in August. Many countries can be expensive in the summer months and much less so in autumn. November and December can make fine months for entertainment in many European countries. There may be concerts and musical events more often than during the summer. Milan, Rome and Hamburg, not to mention Berlin, Vienna and Madrid are most often mentioned for music. Most of my friends and I wouldn’t miss the chance to try the exciting, interesting and appetizing menus at most continental restaurants. In many European countries food is inexpensive and interestingly prepared. Servings may be small but meals are taken more often so that there is no need to go hungry. Maritime countries make many meals of seafood, such as mussels, clams, shrimp, flounder, and salmon or herring. Planning and making your own meals cannot be done even in most small, inexpensive hotels. One must eat in the dining room or in restaurants. Much fun can be had meeting the local inhabitants during mealtimes. Most of them can tell you where to find amusing and interesting shops and sights not mentioned in tour manuals.

Recording Formal perceptual analysis needs a recording. Apart from the shortest of the assessments, it is impossible to accurately rate voice aspects while engaged in a real-time communication. Unless you record, there is no ‘hard evidence data’ to share with others or to compare with a second profile at a future date.

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Having explained why you are recording, and what will happen to the recordings, it is always important to ask the speaker’s permission to record. In an increasingly litigious world, it is also advisable to have clients sign a formal permission form. Some acting courses record their students at regular interval during training; it is interesting for both teachers and actors to see whether there are changes over that period. A small simple minidisk recorder is a useful tool for any voice practitioner, but better quality devices are desirable for good perceptual voice analysis.

Recording devices This section is written by Evangelos Himonides, Lecturer in Information Technology and Music Technology Education at the Institute of Education, University of London. There are many reasons why a voice practitioner might make a voice audio recording. The recorded voice can be used as evidence for progress and a reminder of challenges during previous sessions, and enable both practitioner and client to review past work. In addition, current technologies provide means for practitioners to carry out analyses of recorded audio data, if they have even a fairly minimal set-up such as a laptop computer and a choice of voice-analysis software. These analyses can be done either at the time or afterwards, in what is called in real-time or post hoc. The principle in audio recording is to aim for the best audio quality possible, in case we want to run computer analyses in the future. Nowadays, with the advances of digital technologies, this can be achieved on even a relatively small budget. (An explanation: having used the ‘buzzword’ digital, I would like to clarify something that is frequently misunderstood; there is no such thing as digital sound! Sound is an analogue phenomenon disturbance in the air that mechanically ‘disturbs’ our hearing instruments. What we call digital sound is merely a stream of information that attempts to describe what the sound sounds like. Having said that, we can automatically infer that not all digital devices describe sound the same way; there are highly accurate descriptions of sound and there are extremely poor descriptions of sound. Do not let the high-street salesman convince you that ‘as it’s digital, it’s good’.) Our assumption is that we want equipment with minimal maintenance, no consumables (e.g. tapes, discs, batteries), high portability, good recording quality, ease of use, connectivity, ability to easily interface with computers and, last but not least, sensible price! The following are the main categories of recording devices: 1. Dictaphones and their new digital offspring: these are useful for interviews and recording reminders. The old (tape) machines are very noisy and the new (solid-state) ones usually record in highly compressed lossy (meaning that part of the information is discarded) format. They are not recommended for recording singing. 2. Minidisk recorders: we need to emphasise the need to check that you are buying a recording minidisk deck. (Many consumers buy an economically priced deck and later discover that it provides only playback.) Minidisks are very useful devices, easy to operate and

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3.

4.

5.

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provide decent audio quality. They should not be used in the singing studio though for two main reasons: the first is that most minidisks record in lossy (see above) compressed format. If we want to perform audio analyses of our recorded material we need to record in uncompressed audio format. We will not be able to perform accurate spectrographic analyses of the recorded vocal output on a minidisk recording that has discarded most information (see above) regarding higher frequencies in the spectrum. Second, minidisk recordings are problematic to back up and transfer. Although most new decks have USB connectivity for interfacing with computers, due to copyright ‘games’ the communication between minidisk deck and computer is unidirectional – and oddly this is from computer to minidisk. So even if the recording is yours, in order to transfer it to your computer, you will have to re-record it using an analogue connection from the minidisk to the computer. This means not only that you will have to spend twice the time, but also that the sound will have to be converted to analogue (before it exits the minidisk) and back to digital (when it enters your computer) for one more time, thus further compromising the sound quality. DAT (or digital audio tape) machines: until recently, these were used by both industry and research as the standard for good-quality two-channel (in common practice, usually known as stereo) recordings. They are not recommended nowadays, mainly because of initial prices, very high costs for maintenance and servicing and, again, difficulties in the logistics of moving and backing up recordings. Stand-alone (hi-fi separates) CD-audio recorders: these machines provide good overall recording quality. They could be used in the recording studio but only if the practitioner has a fixed recording installation. They very rarely have built-in microphone inputs. This means that, in order to use a microphone, you would have to use an additional microphone preamplifier for converting the very low-level microphone signals to hotter linelevel signals. These machines also need to record on special blank media (CD-recordables for audio) that are usually more expensive than the off-the-shelf blank CD-ROMs that we use with our computers. Popular MP3 players with basic built-in recording capabilities: devices such as these are flooding the high-street and internet. Examples include iPods, new mobile phones that double as media players and recorders, Creative Muvos and their siblings. These are not recommended for our purposes. They tend to be noisy, and operate on their built-in microphones. At their best, their sound qualities are similar to those of dictaphones. Professional, two-channel, solid-state, digital recorders: these are the devices that I would suggest using. The new generation of recording devices are very easy to use, do not have mechanical moving parts, and are thus robust and less prone to go wrong. They usually come with quite acceptable built-in microphones but also give you the opportunity to use external ones. They are quite simple to use, light and easy to carry, have built-in batteries and, most important, they record straight onto memory cards and can be connected onto your computers. Transferring a recording from such a device onto your computer is a process identical to transferring a digital photograph from your digital camera onto the computer; the audio recording becomes a digital file that you can just copy and paste. The recording capacity of such a device translates to the recording capacity of the memory card that you are using. If you are lucky, you might find that your camera uses the same format!

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At the time of writing, the main ‘competitors’ in the field are (in alphabetical order): the Edirol R09, the Marantz PMD 620, the M-Audio Microtrack II and the Zoom H4 (or its new smaller sibling the H2). You will find that all are priced quite similarly, at around £220. Recording is an immense field, an endless journey and an ongoing challenge! We cannot provide a fully comprehensive approach to recording in this chapter. For those interested in pursuing this subject further, I recommend the following sources: 1. Voice Science Acoustics and Recording (Howard and Murphy 2007): this book is written ‘in a manner which is rooted in science but which is designed to enable understanding by non-scientists and voice practitioners alike’. The section on ‘How to make a voice recording properly’ is a helpful guide. 2. Basic Digital Recording (White 2004): Paul White is the editor of Sound on Sound magazine. This book is part of his ‘basic’ series and is a pocket-sized gem, at the cost of a high-street cappuccino.

Formal perceptual voice assessment schemes In 1993 Kreiman et al reviewed 57 different research papers that used perceptual analysis in disordered voice, but far fewer formal perceptual voice schemes have been tested in work with voice disorders. Sweden has a long tradition of voice research, and the Stockholm Voice Evaluation Approach (SVEA) is widely used. In the USA, clinicians may use Wilson’s Buffalo Voice Profiles or the Boone Voice Program’s evaluations. In Australia many therapists use the Voice Analysis Profile of Oates and Russell (1998). I describe two perceptual voice schemes in some detail because: • they exemplify very different approaches to the nature of voice quality • they are recommended by the British Voice Association (Carding et al 2001) for anyone working with voice disorders • they have both inspired and influenced the development of the Voice Skills Perceptual Profile described in Chapter 6.

The GRBAS scheme This was developed in Japan and is described by Hirano (1981); all direct quotes in Box 4.1 are from his book. It has become the most common perceptual voice scheme in international use with voice disorders, and is a useful tool for any SLT working with voice disorders – easy to learn, simple to use and has reasonable reliability if judges are well trained (Webb et al 2004). However, it is a ‘voice deficit’ scheme, applicable only in cases of voice abnormality, and presents a limited view of a spoken voice. Its focus on activity and sound produced by vocal fold action excludes any analysis of other contributors to the whole vocal sound. The listener makes five judgements of vocal disorder severity, grading each on a 0, 1, 2, 3 scale. The numbers correspond to a ‘common sense’ foursome of descriptive terms – normal, mildly affected, moderately affected, severely affected (Box 4.1).

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Box 4.1 The GRBAS Perceptual Scale G = GRADE – The general level of the voice quality – ‘the degree of hoarseness or voice abnormality’. 0 = normal (i.e. non-hoarse), 1 = slightly disordered, 2 = moderately disordered or 3 = extremely disordered. R = ROUGH – ‘represents the psychoacoustic impression of the irregularity of the vocal fold vibrations. It corresponds to the irregular fluctuations in the fundamental frequency and/or amplitude of the glottal source sound’. Perceptually it is likely to be heard as a harsh, irregular quality. 0 = no roughness, 1 = slightly rough, 2 = moderately rough or 3 = extremely rough. B = BREATHY – ‘a psychoacoustic impression of the extent of air leakage and is related to turbulence’. This is likely to be heard as a whispery sort of quality. 0 = no breathiness, 1 = slightly breathy, 2 = moderately breathy or 3 = extremely breathy. A = AESTHENIC – ‘denotes weakness or lack of power to the voice. It is related to a weak intensity of the glottal source and/or a lack of higher harmonics.’ This will be perceived as a weak, usually low energy and volume quality. 0 = no weakness, 1 = slightly weak, 2 = moderately weak or 3 = extremely weak. S = STRAINED – ‘a psychoacoustic impression of a hyperfunctional state of phonation. It is related to an abnormally high fundamental frequency, noise in the high frequency range and /or richness in high frequency harmonics’. We will hear this as a tense quality within the larynx. 0 = no strain, 1 = slightly strained, 2 = moderately strained or 3 = extremely strained. Example: a speaker with a moderately impaired voice, with slight roughness, moderate breathiness, slight weakness and significant strain would be described as G2 R1 B2 A1 S3.

Voice story: Nick Nick had a paralysed vocal fold and rated highly in the roughness, breathiness and aesthenic dimensions. His vocal folds could not close normally nor could they produce regular and equal vibrations, and so his voice was weak. He used a great deal of laryngeal tension in order to try to ‘push’ his voice out. At the first session his voice was rated as G3 R2 B3 A3 S3.

British speech and language therapy consensus has agreed that the rating for the Rough, Breathy, Aesthenic or Strained features must not exceed the rating of the overall voice grade (Carding et al 2004, Webb et al 2004). This means that, when a voice is rated as ‘within normal limits’ (G0), any slight roughness or breathy escape cannot be recorded on the GRBAS scheme. This is a real limitation, because these qualities may be highly relevant; a speaker’s voice might sound normal in terms of the general population, but a trained ear might hear some strain that is contributing to his loss of vocal stamina.

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Example 4.1 A teacher has early vocal nodular swellings, and by Friday is straining her voice. A therapist may assess her on a Monday morning, and hears a voice that is within normal limits, so has to rate her voice as a G0 – and therefore R0 B0 A0 S0. Even if the SLT hears signs of excess laryngeal tension and some slight breathiness, this cannot be rated at this first meeting, and will have to be recorded separately. By Friday, the rating might well be G2 R2 B2 A2 S2.

The British Voice Association states ‘competent use of the GRBAS should define the basic level of auditory perceptual evaluation skills required for speech and language therapy clinical practice’ (Carding et al 2001). However, a small study found that only 44% of 69 SLTs routinely used GRBAS, and 40% never used it (Jones and Carding 2005). Any SLT working with voice disorders should use the GRBAS, because it shows change in phonation quality over time and standardises communication with colleagues.

Voice story: Howard Howard was a cantor in a synagogue. He had a significant muscle tension dysphonia (voice strain with excessive tension in the laryngeal muscles) and was rated at G3 R3 B2 A1 S3 Between the first and second sessions, he simply followed suggestions to increase his water intake, use daily steam inhalations and begin to use lower breath support. At our second meeting I rated his voice as G2 R2 B2 A1 S2 – certainly not yet cured, but clearly going in the right direction. After three subsequent sessions of voice therapy, his voice had returned to a normal rating of G0 R0 B0 A0 S0.

THE CAPE-V (Consensus Auditory–Perceptual Evaluation of Voice) – a development of the GRBAS scheme This scheme is an adaptation of GRBAS and included here because it is likely to have an increasing international use in clinical voice work. Robert Hillman (Co-Director and Research Director at the Center for Laryngeal Surgery and Voice Rehabilitation at Massachusetts General Hospital) writes ‘a lot of centers have been using the CAPE-V here in the US for some time including us – we have it in a computerized form’ (personal communication, 2007). The Cape-V form rates six ‘salient perceptual vocal attributes’: Overall Severity, Roughness, Breathiness, Strain, Pitch and Loudness. Although it uses very similar categories to GRBAS, it is a different kind of rating scale. GRBAS is an equal appearing interval scale (EAR); listeners have to assign an exact number to a sample of voice. The Cape-V is a visual analogue (VAL) rating scale. Each parameter has beside it a 100 mm-long line. Listeners make a mark on this according to where they feel that the voice deviates from normal. It is thus possible to show fine gradations in severity, rather than the discrete points of GRBAS, and there is some evidence that the CAPE-V system is more sensitive to small differences

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within and among clients than the GRBAS system (Karnell et al 2006). As the rating mark is made on a 100-mm line, the use of a ruler makes it easy to work out a percentage score – always useful in research.

The Vocal Profile Analysis Scheme (VPAS) The VPAS is based on phonetician John Laver’s seminal work on the phonetic description of normal voice (1980). In the clinical literature the description of voice quality had tended to focus on phonation quality, and Laver provided ‘the first really comprehensive phonetic description of voice quality by specifying laryngeal and supralaryngeal parameters of voice quality’ (Wirz and Mackenzie Beck 1995). He made it clear that the characteristic quality of a speaker’s voice is created by both his anatomy and his learned habitual muscle use as he creates ‘settings’ in a number of different voice aspects. A setting is defined as ‘a product of organic and phonetic contributions towards the long term average configurational tendencies of the vocal apparatus’ (Laver et al 1981).

Example 4.2 Speakers A, B and C may have a similar phonatory quality, i.e. activity at laryngeal level, but sound very different. Habitually, speaker A may speak with a rather rounded lip position and carry his tongue low and back in his mouth, whereas speaker B’s lips may be much more spread, with a raised and forward tongue setting and some degree of pharyngeal tension. Speaker C may have a rather neutral lip and tongue settings, but tend to have a close jaw, marked nasal tone and a very variable pitch range.

Laver used his theoretical framework to develop the VPAS as a clinical voice analysis tool, working with therapists Sheila Wirz and Janet Mackenzie Beck, and Steven Hiller as the project’s acoustic analysis programmer (Laver et al 1981). The scheme can be used to analyse a recording of any spoken voice, whether normal or abnormal, and gives a clear structure for identifying and rating any speaker’s articulatory settings and charting them onto one form – the VPAS protocol. Each setting has a carefully defined ‘neutral’ or standard setting from which the individual’s voice can be compared and rated at a particular scalar degree (SD). The VPAS is rich in its number of parameters and degrees of fine judgements, but this does result in less reliable interjudge agreement than the GRBAS. ‘The VPA may have a use as a multi-dimensional and in-depth evaluation of voice types, but its greater scope is at the expense of reliability’ (Webb et al 2004). However, my own research found that there was a significant improvement in the ability of 38 SLTs to accurately rate vocal quality features as a result of training (Shewell 1998b). Since its inception, the VPAS protocol form has been through several different versions. The 1988 version of the VPAS protocol in Figure 4.3 shows the nature of the parameters and their rating options. Laver and Mackenzie Beck’s later versions have simplified both the form and the scoring system. The case story below used the 1988 version.

Figure 4.3 The 1988 version of the Vocal Profile Analysis Scheme protocol form.

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Voice story: Tom Tom was a young actor who had developed a ‘rough’ voice after a severe bout of laryngitis. He had moved straight into professional acting from amateur theatre. A year previously, in mid-performance, he felt his voice ‘collapsing like a bass guitar with the strings going twang’ and was found to have a small haemorrhage on the left vocal fold. This had long healed but he was still having problems. On assessment, his breath support appeared good, but, in listening to his ordinary conversation, I could hear frequent tight gasps on inhalation. He told me that his friends often knew when he was going to speak by his audible inhalation. The VPAS showed a moderately low pitch mean, narrow pitch range and low pitch variability (all at SD 2). Tom told me that soon after his vocal fold haemorrhage he had deliberately pushed his pitch down when playing an angry Southern States role. He had liked the ‘macho quality’, and decided to keep it in his ordinary voice. This had created problems as he was tightly holding his larynx down (lowered larynx SD 2). His voice had significant laryngeal tension (SD 4), pharyngeal constriction at SD 3 and considerable supralaryngeal tension at SD 4. I rated his habitual jaw setting at SD 2, and minimised (SD 3) range of movement in jaw and tongue settings. Voice work started by releasing his jaw, and once the ‘front’ of his channel began to open, direct work could begin on deconstricting his pattern of throat tension. Exercises on easy phonation then followed, with pitch work on mean and range. He improved significantly in all aspects of voice and was able to ‘naturalise’ a new and easier habitual voice, which was based on modified behaviour of his whole vocal tract.

The development of a new perceptual voice scheme Tom’s story shows the value of the VPAS approach as a guide to understanding the sound of a voice, so that appropriate practical work can be planned. Such structured step-by-step listening enables us to identify the function of different parts of the vocal apparatus, and to see the interrelationship between the behaviour of those different parts. Working laterally on one setting may help to release another. For many years aspects of the scheme helped my work with actors, singers and voice-disordered clients, and I trained many different voice practitioners in its use. In 2000, the BVA Perceptual Voice Evaluation working party, of which I was a member, agreed in discussion that there was a need for a new perceptual scheme that would be reliable, user friendly and useful. As part of my interest in the common ground of voice work, I decided to look into the possibility of developing a perceptual scheme that could be relevant for all voice practitioners. Any new profile would incorporate some of the most valuable GRBAS and VPAS terminology and the latter’s concept of ‘setting’, but would take a wider view of the vocal apparatus. Aspects of body, breath and resonance also needed to be included and I wanted there to be room for both descriptive comments and numerical ratings. These ideas led to the development of the Voice Skills Perceptual Profile, and Chapter 5 sets the scene for that scheme.

Part 3

The Voice Skills approach

Voice Work: Art and Science in Changing Voices. Christina Shewell © 2009 Christina Shewell. ISBN: 978-0-470-01992-4

Chapter 5

Voice skills

The word ‘skill’ means ‘the expertness or practised ability to do something’. It is a familiar word deliberately chosen in the name of the approach because all voice practitioners work to develop ‘practised ability’ in their clients. The ‘Voice Skills’ approach is not a rigid method into which worker or client must be pushed, but rather a common-sense practical synthesis of three tools: 1. A description of eight aspects of the free voice 2. A chronology of Voice Skills work as a guide map for working 3. A related perceptual voice analysis scheme (the Voice Skills Perceptual Profile or VSPP).

No ideal voice As we have seen, the word ‘voice’ has sometimes been seen as synonymous with phonation. In this book phonation refers purely to the activity of vocal fold vibration in producing sound. Voice is defined as sound that emerges from the mouth or nose, powered by breath, produced by vocal fold vibration, and shaped by the vocal tract and resonators. It is affected by the emotional and physical state of the person, and the context in which they speak or sing. Such a definition includes sniffs, whistles, clicks, sighs, groans and laughs, sounds well used in the percussive vocal art of the ‘beat boxer’. Non-verbal vocal noises are variously termed vegetative, emotional, natural or primal sounds. They do not include the rumblings of the active stomach, although Abitbol (2006) speculates that these may have been significant in earliest human communication. ‘Primal’ vocal sounds do not carry unique specific meanings but can be semantically very expressive, and belong within the spectrum of human voice. Brown (1996) says that: ‘all the vocal qualities you were born with are there, ready to use, if you can only find the key to unlock them. They are a function of the autonomic nervous system.’ Although many primal sounds are involuntary, they can be consciously produced, and can act as a ‘key’ to the free voice. Chapman (2006) uses the concept and practice of primal sound as a core part of her singing teaching methodology.

Voice Work: Art and Science in Changing Voices. Christina Shewell © 2009 Christina Shewell. ISBN: 978-0-470-01992-4

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Whatever the vocal sounds that emerge from a speaker or singer, few voice practitioners attempt to define an ideal voice to which all should aspire. Hollien (2000) rightly points out that ‘what might be ideal in one situation, might not be suitable for a second’. A voice is influenced by personality, context, environment, style of use and many other factors. Many voices, described as ‘slightly peculiar’ by some listeners, may be considered attractive by others and as an essential part of a speaker’s personality. Even the difference between normal and abnormal proves difficult: ‘an accepted definition of normal voice does not exist . . . normal is not a single state but rather exists on a continuum (Colton and Casper 1996). Nevertheless some writers attempt a description of a ‘good voice’. Wilson (1987) defined it as having: • • • • •

a pleasing voice quality a proper balance of oral and nasal resonance appropriate loudness speaking fundamental frequency level suitable for age, size and sex appropriate voice inflections, involving pitch and loudness. Hollien suggests that it:

• • • • •

has a lower than average habitual pitch level has a softer rather than a louder voice level has variability in both loudness and pitch has a slower than average speaking rate will ‘not exhibit noise’ (such as breathiness, harshness).

Both these definitions include highly subjective terms, such as ‘pleasing’, ‘proper balance’ and ‘softer rather than louder’. Voice teacher McAllion (1988) takes a more pragmatic approach and says a speaker should be able to: • use the voice without hurting himself in the process • use the voice voice fully and energetically for as long as she wants in a day with no deterioration of flexibility during that time • convey all the accuracy, subtlety and emotional expression needed for work demands, with the voice remaining ‘absolutely under your control’.

The free voice Any prescriptive idea of a perfect voice denies the value of the variety of individual voices, but practitioners comfortably use words such as ‘healthy, expressive, connected, open, released, flexible’ as desirable attributes in a voice. These do imply a common view about what constitutes a well-functioning voice – whether in an operatic tenor, a Shakespearean actor, a public speaker or a client with vocal nodules. Core to this idea is the concept of vocal ‘freedom’. Berry (1994) says such a voice is ‘one that is open and reveals the person. It is when the whole physical being of the person is reflected in the voice, and this happens when you allow yourself to be open to the breath’. Rodenburg (1992) says that ‘nothing is quite so freeing and enlarging as a liberated voice’ and distinguishes the ‘natural’ voice from the ‘habitual’, which may be ‘encrusted with

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restrictive tendencies that only awareness and exercise can undo and counteract’. Linklater (1976) described the aim of her approach as ‘designed to liberate the natural voice rather than to develop a vocal technique,’ and in 2007 writes that ‘there is a vital difference to be observed between what is natural and what is familiar’. Houseman (2002) comments on the fact that the tension habits of many adults can limit the ‘great posture and expressive voice, full of range and colour’ of healthy toddlers – which ‘they can use incessantly without getting a sore throat.’ The singing teaching literature also expresses the idea of the free voice, and that natural vocal power may be cramped by negative patterns and influences. Chapman (2006) writes ‘everyone is in essence a singer but in modern society we suffer from overcrowding, noise pollution and emotional constipation’. Miller (1986) writes of ‘the freely functioning voice’ and Brown (1996) uses the phrase ‘free your voice’ as a section heading in his first chapter. The concept of the free voice has no value judgement involving perfection or beauty and, although not part of medical or voice therapy terminology, it implies a healthy or ‘unconstricted’ voice. If a voice is free, it has the potential ability to move anywhere along the human voice pitch range, to imitate or produce any particular quality, resonance or volume. It can soar, croak, whisper, shout, squeak and growl, and talk for hours without tiring, weakening or straining. The definition of the free voice and linked Voice Skills approach developed during dayto-day work experience with a variety of clients. In my first voice teacher job I found myself struggling to become clear about the process of training the actor’s voice. I had, in theory, been taught to facilitate the development of a strong, flexible acting voice and had lots of practical ideas. What was lacking, however, was a clear view of the logical process of training a voice, to guide the shape of a session or a term. I made many mistakes, but reflecting on them and on what worked well, together with discussion with my colleagues, helped me to build a coherent picture of the sequence of technical work. Inherent in my thinking was that it was important to be clear and specific about the nature of exactly what was wanted in the young actors’ voices. I also became aware that there was often a loose linear order in the development of the free voice. Any chronology of voice work would never be rigid but it could act as a map; I could choose to follow the main roads, take a side route or even run across a wild meadow at any point. Along with my work as university lecturer, therapist and voice teacher, I often worked in partnership with singing teachers. Using a notebook, I collected the statements that my colleagues made about voices that we heard, and did an informal ‘factor analysis’ on them to look at what the main parameters of a desired voice appeared to be. Comments included: She sounds so tense. Her voice has really released since her posture got better. He’s unusually low pitched. His voice is very backed, not good for RP or for carrying across the stalls. Her breath support is wonderful on those long notes! That creaky quality is really annoying. She’s straining her voice on the top notes in that song. Loads of jaw tension. Sloppy consonants! He’s so calm and measured – sounds like he’s got all the time in the world.

74 Voice Work: Art and Science in Changing Voices I think she’s tight in the throat but it sounds like it goes further up as well. He’s discovered his chest resonance but it’s a rather tedious sound. That accent is difficult for us to pick up because it has such a different rhythm. Her presentation is great – so much variety and energy. It’s not surprising she’s developed nodules – she’s got so much laryngeal constriction.

From these descriptive comments and from the voice literature, I defined the free voice with reference to eight core voice parameters, deliberately using terms that would be familiar to most who work with voice change. These parameters are perceptual and functional vocal aspects. They are not separate boxes or levels, but intertwined strands and spirals that work together with personality, emotion and spirit in the complex, ultimately mysterious human voice. However, when appropriate, the eight aspects do lead to the notion of distinct areas of voice on which we can turn the light of our attention and the energy of our action (Box 5.1).

Box 5.1 The free voice 1 is based in a BODY that is as free as possible from habitual awkward postures and excess tension. 2 is powered by BREATH that flows from low in the body, and can support a variety of physical and vocal activities. 3 has a passage through the CHANNEL with appropriate settings of face, lips, jaw, tongue, soft palate, pharynx and larynx and no excess muscle constriction. 4 has PHONATION which will vary appropriately according to mood and energy but is not excessively rough, breathy or creaky, nor will the quality significantly change with long or demanding voice use. 5 has an appropriate balance of head, oral and chest RESONANCE qualities with an appropriate sound of forward ‘placing’ in the mouth. 6 has an appropriate centre PITCH with flexible range for any emotional, semantic or vocal need. 7 has a flexibility of LOUDNESS for emphasis, variety and different situations, with an appropriate power support. 8 is shaped into appropriate words by clear, energetic ARTICULATION of vowels and consonants, with appropriate pace, pause, fluency and rhythm.

Eight aspects of the free voice 1. Body: the words ‘a body that is as free as possible from habitual awkward postures and excess tension’ are carefully chosen. Many people have congenital or acquired physical restrictions that cannot be changed, and voice work will work within those boundaries. As we have seen, a healthy degree of tension in our muscles is essential; the reference to ‘excess tension’ implies that it is this extra stiffness or shortening of the muscle fibres that causes problems. 2. Breath: ‘powered by breath that flows from low in the body’ avoids a rigid description of exactly how everyone should breathe, but the approach shares the common underlying

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conviction that breath best gives support to the voice if it is generally ‘placed’ lower rather than higher within the torso. It will then involve the use of the abdominal muscles, rather than the upper accessory muscles and is more likely to allow better breath outflow control; the subglottic air pressure (i.e. the force of the air below the vocal folds) is more likely to be maintained, to prevent the laryngeal muscles constricting to ‘push’ the voice out. The channel runs from the level of the vocal folds to the front of the lips or nostrils. The free voice should have no excess or inappropriate tension in the muscles of the face, lips, jaw, tongue, soft palate, pharynx and larynx that would negatively affect the flow of air, quality of sound or health of the structures. Phonation refers to laryngeal settings, aspects of the vocal folds as they open and close in fast vibrations. The approach uses the terms roughness and breathiness (from the GRBAS scheme), and Laver et al’s (1981) creak for phonation qualities. It also considers phonation stamina – the ability of the vocal folds not to become significantly fatigued or strained during the typical voicing needed by a speaker or singer. The Voice Skills approach uses the terms ‘head, oral and chest resonance qualities’, and the reason for this choice is explained in Chapter 11. The free voice will have a mix of resonance qualities; if there is too much focus of one rather than all of them, the voice will sound imbalanced. If there is back-of-throat constriction there will be an auditory impression of a backed resonant quality; the free voice has a ‘forward-in-the-mouth’ quality of sound. A speaker whose voice is free will have a habitual average pitch that seems neither too high nor too low for the age, gender and personality. The pitch of his voice will move up and down as he speaks and will adapt to mood, thought, word and intention, with an appropriate range of pitches. Writing about the singer’s pitch, Miller (1986) says ‘the free voice is a rangy voice’, and this is also true for the spoken voice. There will also be variety within that range, with no continually repeated stereotypes of particular intonation contours, e.g. no repetitive falling or rising line in sentences. We need to be loud enough for where we are voicing, in terms of the task and the space, but be able to adapt to different contexts – neither being too strong nor too soft in loudness. The free voice will also have a variety of loudness, with the louder pulses of sound needed for emphasis of words or thoughts when necessary. The power for that loudness will be connected to breath, with no excess laryngeal constriction. Articulation is a ‘blanket box’ term, which contains several aspects of the voice that relate to the ways that meaning appears as words and sentences. Regardless of language or accent, the free voice will have clearly audible pronunciation of the speech sounds (consonants and vowels). In terms of four core prosodic aspects of speaking, there will be a variety of pace (speed), which will be neither too fast nor too slow, pauses will be used when necessary (silence is an important as sound), and fluency and rhythm will not be excessively disrupted.

A cautionary note When we listen to someone’s voice under the eight headings in Box 5.1, we may observe all sorts of things that would not be considered ‘free’. Sometimes we will be asked to work on those aspects to enable the voice to be healthier, more effective or more satisfying for

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the speaker, but sometimes no change will be wanted or required. Some people have a habitual pattern of high and shallow breath and never have any voice strain; some speak with a very tight throat and never develop a voice problem; some use excessive nasal resonance, or have a very high habitual pitch, or a monotonous, quiet and weak voice, but it does not bother them or those close to them. In fact, vocal aspects that a voice practitioner might consider to be disturbed may serve a speaker well in terms of his personality, social group or artistic performance demands. For instance, the singing voices of many successful singers can be ‘technically’ limited. The voice of singer/song-writer Leonard Cohen is rough and breathy and has a habitual low pitch with limited pitch range, but it is an essential part of his style, his personality and his power. So too are the particular voice qualities of Rod Stuart, Bob Dylan and many other popular singers. It is the same in speech. Some naturalistic television drama requires its actors to sound almost dysfunctional, whereas certain exaggerated voice qualities may well serve a particular group. Australian speech and language therapist (SLT) Jan Baker points out (personal communication, 2007) that the voices of drill sergeants need to have significant head resonance as they shout instructions to soldiers. For normal voice use, this would be considered unpleasantly excessive, but this quality carries power and energy across an outdoor open space. We cannot be rigidly doctrinaire about what works in a voice, because the person/voice link is so idiosyncratic. Most voice practitioners would say that a speaker with a very quiet, unemotional, monotonous speech would lack impact with a live audience. But sometimes a speaker’s voice lacks volume, energy and variety, and yet their quiet personal power and intense commitment to their message are so deep that the words seem stronger because of that very lack of emotion or ‘voice skill’. There are many voices out there, and the concept of the free voice is never a prescription for all, because the sum of a person’s voice is always bigger than the sum of the parts that make up the sound.

A chronology of voice work Most people are born with the potential for great strength and energy in their voices. Anyone who has heard a baby crying or a toddler shouting will know the power and freedom of the young body’s voice. We do not need to teach children to voice in the way that we teach them to read or to write, and provided that there are no emotional, social or physical blocks, young children quite naturally acquire voice skills. It is only gradually that personal emotions, cultural pressures or social deprivation can inhibit the developing voice. ‘Voice power’ and oracy training would be a valuable option for many students at secondary school level, but the concept of work on voice skills would seem strange to much of the population. Although it is often not made explicit, many writers at least imply that there is a loose chronology in voice training or remediation. This is often clearest in the voice teaching books. Thurburn (1939) made clear her own belief that ‘the order which will be most satisfactory educationally’ was breathing, articulation, resonance and pitch. Berry (1973) writes ‘in practice you must observe this progression’, when advising actors on working the whole voice for text exploration. Rodenburg (1992) progresses through body, breath, freeing and placing the voice, and on into range, resonance and volume control, level and

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projection. Houseman’s headings for her 2002 book, Finding your Voice follow through body, breath, support, releasing the sound, resonance, range and articulation. Most clinical voice books have only an implicit order in their practical suggestions. In a rare collaborative SLT and voice teacher book, Martin and Darnley (1992) are unusual in that they describe their exercises as being ‘presented in an order which takes account of a logical sequence of intervention/remediation’ [my italics]. Their wide range of practical exercises follow through posture, relaxation, breathing, note onset, pitch, muscular flexibility, variety, resonance, volume and role play. Mathieson (2001) says ‘by following a logical but flexible hierarchy, the patient is able to make steady, comprehensible progress’. Colton and Casper (1996) point out that if a technique is ‘but one phase of a progression, the patient needs to have a sold foundation on which to build’. For singing teachers Miller (1986) writes ‘although the art of singing can be learned only through singing, the systematic organisation of vocal technique is the most efficient route to the realisation of the primary goal: production of beautiful sound’. Chapman (2006) uses ‘incremental’ to mean that ‘singing can be broken down into manageable components and that these components have a natural hierarchy’. The model in Box 5.2 suggests a core chronology of Voice Skills work from which a voice practitioner can choose a menu for individual or group work. A sense of linearity in voice work does not mean that there will ever be rigid adherence to a narrow order, because voice work also needs to have the improvisation needed to adapt to an individual or group. Although the different aspects grouped under articulation come last in the list, direct muscular work on sounds helps to free up the channel and balance the resonance, and can also have the effect of enlivening the body and breath of the participants in a group. Spontaneity is vital; for all of us who work with voice, whether in a medical or an artistic context, some of the best exercises are invented at the moment of creativity when practitioner and client are in tune with each other. But spontaneity needs a foundation of experience. The fact that we have at some point learnt a good chicken soup recipe allows us to improvise with whatever suitable herbs and spices are to hand, or even to leave out the chicken! Most of us do

Box 5.2 A Voice Skills model of practical work A PROGRAMME OF VOICE SKILLS WORK 1 BODY POSTURE

and TENSION POINTS in STILLNESS and ACTION 2 BREATH ABDOMINAL AREA RIBS in BREATH PLACING AND CONTROL LOWER BACK AREA 3 CHANNEL FACE LIPS

JAW

TONGUE

SOFT PALATE

PHARYNX

LARYNX

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4 PHONATION MANNER OF VIBRATION OF VOCAL FOLDS including regularity of the vocal fold vibration, amount of air escape, thick/thin dimension of the vocal fold, and other relevant factors. 5 RESONANCE HEAD AND ORAL QUALITIES CHEST QUALITIES RESONANCE BALANCING 6 PITCH CENTRE RANGE and VARIETY 7 LOUDNESS OVERALL LOUDNESS LEVEL 8 ARTICULATION WORDS SPEECH SOUNDS

PACE

LOUDNESS VARIETY PAUSE

FLUENCY

RHYTHM

need to start with some sort of a plan, and the Voice Skills chronology makes explicit a basic foundation. Box 5.2 provides a template of the core practical work that logically follows from the notion of the free voice parameters. The physical foundations of each voice skill is described in the relevant chapters of Part 4; a brief introductory summary is given below: 1. Body: we start with work on the body, checking out the client’s postural habits and tension points, and working practically if necessary in whatever exercises seem appropriate. These may be done in movement or in stillness – energetic dynamic action or quiet inwardly attentive immobility. 2. Breath: both placing and control are relevant. Various muscles in the abdominal, rib and back areas are active in breathing, but usually the action of one area is more noticeable than the others, and it is to this that the word ‘placing’ refers. Control refers to the length of time that we can prolong an out-breath, and to its coordination with other voice aspects. 3. Channel: a client may need direct exercises to eliminate excess tension, or to build up and extend healthy tone and activity in the muscles of the face, lips, jaw, tongue, soft palate, pharynx and larynx. We need to attend to the channel before working directly on vocal fold vibration. 4. Phonation: direct exercises may be needed if the vocal folds vibrate in a way that produces a phonation quality that has too much breathy air escape, too much roughness or creak, too much ‘hard attack’, or an unstable sound that varies uncontrollably in one or more dimensions. There may also need to be work on enabling the folds to use an appropriate thin/thick dimension, or on other aspects of laryngeal muscle function. 5. Resonance: practical work on different resonant qualities can demonstrate to the client that there are options that he can use; each can be explored in turn, and then work can be done to reduce any excessive quality, because the aim is for a resonance balance.

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Resonance comes before pitch, because sometimes the sense that a voice is placed ‘too high’ or ‘too low’ has to do with resonance rather than pitch. 6. Pitch: the client may need direct work to change his habitual average pitch level. This is less usual in voice work than the need to encourage a wider use of the pitch range, with its high and low options for both speaking and singing. Some clients use a particular rising or falling spoken pitch contour so regularly that it is irritatingly monotonous to listeners, and the practitioner may use exercises to change this. 7. Loudness: this work has two aspects. The speaker or singer needs to be able to produce a loud, strong voice without strain and a soft voice with control, and any public speaker needs loudness variety. Although it is important to be loud enough and loudness has an absolute acoustic correlate (i.e. we can measure the decibel level of a voice), if the previous voice aspects work well, they help listeners to hear the message better. 8. Articulation: direct work on the choice or sensitivity to words and images will depend on the needs of an individual speaker. It is an essential consideration for the voice teacher while the SLT who works with voice disorders will rarely attend to this aspect with his clients. The clarity and energy of speech sounds, and the use of pace, pause, fluency and rhythm, are a vital part of voice and singing teacher work, but less often part of the ear, nose and throat therapist’s work. But if the last also sees clients with neuromuscular speech problems or those who stammer, direct exercises on these aspects will be core to the work. As we have seen, inherent in the Voice Skills approach is the idea that all aspects affect each other, and this can be seen in the way that the spoken voice of a pupil can strongly affect the sung voice. If a singer is speaking for many hours each day with excess constriction at one or more places along their vocal tract, that channel of sound will not necessarily easily release that tension when singing. Although there is flexibility within the chronology, work on earlier aspects can often help to free up or to release other aspects. We can see this in a few examples.

Body and breath work before channel work If a client has a ‘tight’ voice, with excess constriction in the muscles around the larynx, it is important to ensure that the shoulder, neck and back muscles are as free as possible from excess tension, and that there is good head and neck alignment. We also need to check that there is adequate air pressure to blow the vocal folds apart without excess laryngeal tightening. These considerations can be relevant even when the voice problem is part of a general neurological condition, such as Parkinson’s disease, because a few simple body-based exercises can warm up muscles, attention and energy levels before direct speech and voice work.

Bodywork before pitch work If a speaker has a restricted and rather dull pitch variety in his voice, pitch variety work alone may not be effective if the speaker’s posture remains stiff and completely

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unmoving in presentations. It takes a conscious effort to speak the words ‘I’m going to have an enormous meal’ in a monotone, while running up and down the stairs, or waving both arms enthusiastically! Encouraging an over-articulation of the lips can stimulate some clients into a new pitch variety, with no instruction to do so; it is as if the front of the mouth feels more lively and that ‘lifts’ the pitch variety.

Body and channel work before speech sound articulation work Some elocution teachers used to focus intensively on the articulation of speech sounds, without recognising that underlying the unclear vowels was an overall tendency to hold tension in the tongue and throat, which itself was related to a generally tight body.

Resonance work before centre pitch work Often appropriate work to reduce excess chest resonance quality and encourage forward placing in the mouth will allow a ‘lighter’ vocal quality without the necessity for direct higher pitch work. Attention to the first five aspects is vital before we try to do something as psychologically disturbing as change the habitual level of spoken pitch.

Voice story: young tenor I was asked by a talented young tenor to help him raise the basic pitch of his voice, since an inept ENT surgeon had told him that he spoke ‘too deep for a tenor and for the length of his vocal folds’. He worked hard to incorporate this instruction into his natural speaking voice for ordinary life, but felt very false and arrived at our first meeting with a heavy sense of depression. In fact, he was simply using much too much chest resonant quality since he liked the ‘manly’ feel it gave him. Once we had opened up his ability to better balance his resonance by using more head resonant quality as well as a more forward focus in his mouth, his whole voice sounded lighter and higher and there was no need at all to work on his habitual average pitch level.

Multi-aspect work to increase volume Sometimes a speaker simply feels that they want to sound louder. Practical work on all eight aspects encourages the use of the whole body as a ‘sounding board’, a powerful instrument out of which strong sound can stream out.

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Voice story: self-defence A woman friend was attending self-defence classes. She told me that when told to yell as loudly as possible in the face of an assailant, she found herself unable to shout. She said ‘I was just frozen – just a pathetic thin shriek came out’. I showed her how to loosen up her body, find a stable ‘oak tree legs’-based posture, use abdominal breath as a power source, and open the channel. She could then use the appropriate strong glottal (vocal fold) attack with wide-open resonance and a comfortable centre pitch, and produced an enormous sound.

At a British Voice Association conference, international soprano, Elizabeth Söderström, told a story of singing a top note in the face of some would-be muggers – and seeing them vanish! If the voice is free, the sound can usually be as big or as small as a speaker wants. Chapter 6 describes the way that the Voice Skills headings are used as the basis of a perceptual analytical model to describe and rate what is heard in a voice.

Chapter 6

The voice skills perceptual profile

Rationale behind the Voice Skills Perceptual Profile In Chapter 4 we saw how the ‘structured listening’ of a scheme such as Vocal Profile Analysis gave useful insights for voice therapy with a young actor. A systematic perceptual analysis can sometimes be relevant in the teaching of singing. Singer Paul Kiesgen (2002) wrote: ‘I had always been pressing my sound. No teacher I had encountered had ever said as much or offered any kind of suggestion that helped me to cure the problem. I had worked hard on breathing strategy and on such resonance ideas as cover. I had also been asked to “drink in the tone”. This idea, I imagine was intended to counteract my tendency to press, but only resulted in retraction of the tongue and jaw and caused even more throat tension.’ A suitable structured listening scheme might have helped one of Kiesgen’s teachers to identify that laryngeal and jaw tension and tongue retraction. As we have seen, speech and language therapists increasingly need to prove that their work is effective and, although there is much good research going on, there could be far more in ordinary voice therapy practice. Many clinicians with a heavy caseload are deterred from using a test that gives them numbers rather than descriptions, or a tool that assesses only a small part of the voice. This is often the way in the practical professions – a conflict between what is seen as the art of practice and the science of research. My aim was to develop a pragmatic perceptual voice scheme that could be useful to any voice practitioner. If such a tool could allow for both qualitative description and numerical evaluation, it might satisfy both intuitive need and reason-based criteria. A voice practitioner could note personal observations under certain ‘common-sense’ parameter headings, using his own choice of vocabulary and comments. This qualitative information could help guide the direction of appropriate voice work for a client. On the same protocol there would also be the option of rating those parameters to generate quantitative information for pre- and post-training results in record keeping, research and comparison. Such a scheme should try to fulfil certain criteria: 1. It should offer useful insights into vocal problems of quality or usage along the continuum of voice from severely disordered to well trained.

Voice Work: Art and Science in Changing Voices. Christina Shewell © 2009 Christina Shewell. ISBN: 978-0-470-01992-4

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2. It should therefore potentially be useful to all voice practitioners to describe and assess an individual’s spoken voice. 3. It should acknowledge inspiration and terminology from the best insights in the existing perceptual schemes. 4. It should be based on an underlying theory of healthy and ‘desirable’ voice. 5. It should be supported by existing knowledge of anatomy, physiology and speech science. 6. It should enable a voice practitioner to listen to and describe a speaker’s voice in an exhaustive, economical and consistent way. 7. Parameters and specific aspect names should, whenever possible, use terminology familiar to a variety of voice practitioners. 8. The numerical rating aspect should be based on a 3-point scale. 9. It should aim to have good interjudge reliability. Feedback on the Voice Skills headings on practical voice courses over 10 years had consistently suggested that they were acceptable and useful to a variety of voice practitioners. I decided to use those parameters as the template for the scheme, and to incorporate what was found most useful from the VPAS and GRBAS schemes. The development of the Voice Skills schemes have been improved and shaped by invaluable comments from colleagues, students and course participants. The approach offers two options: 1. The Voice Skills Framework is a ‘headings-only’ form that allows the practitioner to note down key observations, explorations and client comments under the eight Voice Skills headings. It includes a section at the end of the form for action planning. 2. The full Voice Skills Perceptual Profile (VSPP) is for the listener who wants to follow a systematic step-by-step approach through the eight core parameters with specific tasks and questions, most of which generate numerical ratings.

The Voice Skills Framework The Framework can act as a kind of perceptual filing system to organise what is heard and seen in a voice into written form. It can also act as a simple internal model to guide listening. Sitting in a darkened theatre, with the brief of learning about the technical aspects of an actor’s voice as she performs, I may simply ‘think my way’ down the list. The Framework is equally a habitual tool at the first meeting with a voice therapy case, a singer with apparent vocal strain or a nervous politician.

Box 6.1 The Voice Skills Framework Headings THE VOICE SKILLS FRAMEWORK NAME OF CLIENT

AGE

DATE OF ASSESSMENT

PRESENTING VOICE ISSUE SPEAKER’S OWN WORDS ABOUT HIS/HER VOICE

84 Voice Work: Art and Science in Changing Voices

1 BODY: posture, movement, muscle tension, vocal tract sensation, health and body 2 BREATH: placing and control 3 CHANNEL: face, lips, jaw, tongue, soft palate, pharyngeal, laryngeal 4 PHONATION: rough, breathy, creak qualities, phonatory stamina and other features 5 RESONANCE: features of head, oral and chest resonant quality and focus of oral placing 6 PITCH: centre range and intonation patterns/variety 7 LOUDNESS: overall loudness level, variety and control, and use in emphasis 8 ARTICULATION: consonant and vowel clarity, pace, pause, fluency, rhythm OTHER RELEVANT ASPECTS FOR VOICE WORK

Example 6.1 Voice Skills Framework: singer example Janet is the classical soprano described in Chapter 1. Although still a student, she was already doing a number of professional performances, but had problems with a quality of excess tension and backing in her singing voice. Her teacher said that she tended to ‘swallow’ words in fast singing and her clarity then suffered. Janet herself told me that she found it an effort to speak over any loud background noise; even though she had no problem in filling a concert hall with her singing voice, she could not make her speaking voice ‘loud enough’.

My first task was to translate these auditory impressions of back placing, word ‘swallowing’ and limited loudness into an understanding of muscle function, and I used the Framework form. The notes made at the first session are included in Box 6.2, with a summary of my conclusions below:

Box 6.2 Janet: Framework Headings THE VOICE SKILLS FRAMEWORK NAME OF CLIENT Janet

AGE 22

DATE OF ASSESSMENT December 2006

PRESENTING VOICE ISSUE Singing student, soprano – already regular performances in concerts and local opera. Sent by teacher who says ‘problems placing singing voice, sounds backed and tight’. No ENT problem SPEAKER’S OWN WORDS ABOUT HIS OR HER VOICE

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‘I do recognise that I can sometimes swallow my sung words. Actually I’ve never much liked the sound of my spoken voice, it sounds quite muffled and heavy when I hear it on a recording. Often when we’re out in a noisy place, it’s really difficult for me to make myself heard – more than my friends I think. I so wish that I didn’t have any problems.’ (CS says ‘Can you say what that would mean?’) ‘Well my voice would always sound clear and open and strong – which it does when I’ve really worked hard to warm-up – but it shouldn’t be such an effort.’ 1 BODY: posture, movement, muscle tension, vocal tract sensation, health and body Fit and well – plays badminton twice a week. No aches or pains, or excess tension in relevant muscles. Posture appears ok – but seems to hold neck and shoulders rather stiffly – I mentioned this to her and she says she is ‘working hard’ on what she believes to be good Alexander head/neck alignment. 2 BREATH: placing and control Good breath control (sss = 38, zzz = 31) and placing clearly ok for singing. But interesting to see her use a pattern of laryngeal over constriction in raised volume task, and in fast conversation there is obvious upper chest breath pattern with some audible inhalation. 3 CHANNEL: face, lips, jaw, tongue, soft palate, pharyngeal, laryngeal Brought up in Liverpool – only very slight accent, but tongue certainly has habitual raised back setting in ordinary talking. In itself – not a problem, but Jenny does have a minimised range of tongue movement and the tongue sounds tense. I asked J to do the ‘jiggle exercise’ to test tongue root tension, and she is markedly tight there. Some pharyngeal constriction. Habitual jaw pattern is closer and tighter than I would expect in a classical singer. 4 PHONATION: rough, breathy, creak qualities, phonatory stamina and other features Slightly breathy pattern in speaking – but within normal limits. Does have tendency to glottal attack when she raises her loudness level in speech tasks, and this is particularly obvious when I asked her to sing high and loud on an intoned eeeee. 5 RESONANCE: features of head, oral and chest resonant quality and focus of oral placing Resonance quality sounds backed and ‘held’, probably as result of excess tongue/ pharyngeal constriction. 6 PITCH: centre, range and intonation patterns/variety Fine. 7 LOUDNESS: overall loudness level, variety and control, and use in emphasis Constricts when gets louder. 8 ARTICULATION: Consonant and vowel clarity, pace, pause, fluency, rhythm Consonants clearly pronounced, but they and vowels tend to sound muffled; I think this is a combination of the tight jaw and tongue in her habitual speaking pattern, and the fact that she speaks very fast.

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1. Janet’s teacher says that her spoken voice is ‘backed and tight’ – contributors are her close and tight jaw setting, and her tongue has limited range of movement from its habitually predominantly backed position. 2. The warming up process wakes up her muscles and encourages an open channel and freely moving tongue. She then feels her singing voice to be ‘clear, open, strong’. These settings are not part of her habitual spoken voice pattern, but should be. 3. We will need to do some conscious strong voice work based on abdominal breath coordination, laryngeal deconstriction and related projection skills. 4. She needs to work on jaw release and tongue mobility, and to bring the vibrations forward in the mouth. 5. Head–neck alignment needs checking – send her back to a good Alexander teacher for a refresher session.

Example 6.2 Voice Skills Framework: lecturer example Eugene was a very busy academic in a university department of mechanical engineering. He had invented a new piece of machinery, and was therefore in great demand as an international lecturer by the company that he had set up to manufacture it. His voice problem was of severe concern to him; he often had to speak for many hours in a day, and found it uncomfortable and tiring to talk with the vocal strain that he felt. He was seriously worried that things would get worse, and he would have to stop doing all he did. An ENT surgeon found no abnormality in Eugene’s larynx and sent him to me as a muscle tension voice therapy problem.

Box 6.3 Eugene: Framework Headings THE VOICE SKILLS FRAMEWORK NAME OF CLIENT Eugene

AGE 46

DATE OF ASSESSMENT February 2007

PRESENTING VOICE ISSUE Voice strain and fatigue when talking and/or teaching. No vocal fold abnormality – ‘muscle tension dysphonia’. SPEAKER’S OWN WORDS ABOUT HIS OR HER VOICE ‘When I lecture or talk for any length of time, my voice gets dry and raw, my neck muscles feel tight and I am aware of really having to push the voice out, it feels it’s caught in my chest and won’t come out of my mouth. My wife says I mumble. I want to be able to speak freely and for hours at a time with no problems.’ 1 BODY: posture, movement, muscle tension, vocal tract sensation, health and body Tall and fit looking with no obvious postural problems. Tendency to poke head forward when talking with energy or volume. I could feel some excess tension in shoulder muscles and significantly increased tension n the side of neck and laryngeal muscles; he has been

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having osteopathy to help this. Rates his throat and neck discomfort as significant if he speaks for more than an hour. Broke collarbone during rugby aged 15 when fellow player landed on his chest. Osteopath feels injury relevant as larynx still slightly displaced to side. Fit and well – plays golf once a week. 2 BREATH: placing and control Upper chest pattern of breath visible when talks, and in the assessment tasks. Told me he had never thought about the breath placing but is aware that does not use abdominal muscles in speech. Limited control, just average; sss = 13–15 seconds zzz = 14 seconds 3 CHANNEL: face lips, jaw, tongue, soft palate, pharyngeal, laryngeal Limited range of lip and jaw movements, close habitual jaw position. Tongue also sounds limited range although all consonants and vowels clear. Slight pharyngeal tension and significant laryngeal tension – a real impression of a ‘grip’. ‘I often feel dry in my throat, but when I talk a lot, I also feel like I’m producing too much sticky mucus there.’ 4 PHONATION: rough, breathy, creak qualities, phonatory stamina and other features Slightly creaky and rough phonation, with a tendency to hard onset on vowels. Major stamina problem in that voice feels so strained after even an hour of talking. 5 RESONANCE: features of head, oral and chest resonant quality and focus of oral placing Laryngeal tension reduces chest resonance. 6 PITCH: centre, range and intonation patterns/variety Pitch mean is fine, but Eugene has markedly limited pitch range, so his voice gives impression of slight monotony – though actually quite good variety within the narrow range. 7 LOUDNESS: overall loudness level, variety and control, and use in emphasis General audibility is fine, but laryngeal constriction when raises vocal energy and volume. Good variety and use of emphasis– energetic and lively speaker. 8 ARTICULATION: consonant and vowel clarity, pace, pause, fluency, rhythm Fast, lively speaking pattern, consonants and vowels clear and good use of pause and emphasis. Rather ‘mono-fast’ – more pace variety would make him more interesting.

I wrote this analysis at our first meeting and gave Eugene a copy, because he was interested to see the contributors to his voice problem. We agreed on a plan of action over the next five sessions that related to the Framework description. My notes on specific action aims were:

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1. An intensive month of increased water intake and steam inhaling. (His description of a dry throat with sticky mucus if he talked too much suggested that the mucous membranes of his vocal tract were not adequately hydrated.) 2. Work on better head/neck alignment when voicing. Use semi-supine floor work for general release. 3. Establish a new habitual pattern of lower breath placing in both silence and speaking. 4. Change his habitually close, tight jaw setting – open up mouth! 5. Deconstriction work to release the long-term habit of excess tension in his pharyngeal and laryngeal muscles. 6. Open up chest resonant quality. 7. Work to extend pitch range to give more rise and fall – resulting flexibility in vocal fold tension is also likely to be of benefit. 8. Work on the different aspects of voice projection to enable Eugene to be able to use his voice both loud and long, without strain or discomfort. Over a period of several sessions Eugene’s voice and throat discomfort significantly improved. He told me that the most important insight was the recognition of his own body tension levels, and said that learning to let go and breathe in the semi-supine position, described in Chapter 17, had made an enormous difference to his life. Other examples of the Voice Skills Framework are given in Part 6.

The Voice Skills Perceptual Profile This section outlines some of the more salient aspects of the VSPP, but, like any perceptual judgement rating scheme, practical training is needed for an in-depth understanding of procedures, terminology and rating standards. Courses offer extensive listening practice in all the qualities, as participants produce the different voice qualities and identify them in a range of different voices. (selected samples)

Box 6.4 The full Voice Skills Perceptual Profile VOICE SKILLS PERCEPTUAL PROFILE: DESCRIPTIVE AND QUANTITATIVE © Christina Shewell Name of client:

Voice Issue:

Age/date of birth: Date of assessment

ENT findings: (if relevant)

Assessor: Start recording the session from here. CLIENT’S OWN WORDS ABOUT VOICE (write down exactly what is said)

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Question: Can you describe the sound and feeling of your voice, and why you are here?

CONVERSATION, AND READING OR SPEAKING A TEXT. Ask the client to tell you about something pleasant e.g. an interesting project, holiday or experience; offer brief comments or questions if you feel this will make the speaking more natural. Unless reading is a problem, ask the speaker to read a short passage; if assessing a performer, this may be an already learned text. Ask the speaker to rate his/her own voice, and then later add your own rating. WHOLE VOICE RATINGS 0 = No problems 1 = Slight Problems 2 = Moderate Problems 3 = Severe Problems (Circle relevant number) WHOLE VOICE: CLIENT’S PERCEPTION WHOLE VOICE: VOICE PRACTITIONER’S PERCEPTION

0 0

1 1

2 2

3 3

VOICE SKILLS FEATURES OF VOICE DEFINITION OF A FEATURE: when the specified aspect of voice is judged by the assessor as being a relevant and possibly negative contributing factor to the overall voice, which may indicate a direction for voice work. NUMERICAL RATINGS 0 1 2

No Significant Features. Mildly Significant Features. Markedly Significant Features.

1. BODY 1.a

1.b

1.c

1.d

Posture/Movement: Observe and rate. Ask about musculoskeletal issues.

0

1

2

Shoulder, neck and extrinsic laryngeal muscle tension: Feel and rate.

0

1

2

Vocal tract sensation: Speaker to rate on severity & frequency of discomfort.

0

1

2

Overall physical/ emotional tension: Speaker to rate on 1–10 scale (0 = 0–4; 1 = 5–7; 2 = 8–10).

0

1

2

Any other comments: (general health, past illness or accidents, exercise and fitness etc).

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2. BREATH 2.a

2.b

2.c

Placing: Observe in conversation, and Task: Ask client to count 1 – 10 five times, quickly and quite loudly.

0

1

2

0

1

2

0

1

2

0

1

2

Lips: Rate on range of movement and apparent tension, and describe the ‘setting’ tendency.

0

1

2

Jaw: Rate on degree of open or close setting, and on apparent or described excess tension.

0

1

2

Tongue: Rate on the range of movement and apparent tension, and describe front/back and close/open settings.

0

1

2

Soft palate: Rate on adequacy of audible open/closure setting.

0

1

2

Pharyngeal Constriction: Rate on whether audible constriction.

0

1

2

Laryngeal: Rate on larynx position and laryngeal muscle tension/laxness. Listen for frequent audible inhalation.

0

1

2

Control: 0 = 15 or more seconds; 1 = 8–14 seconds; 2 = 1–7 seconds. Task: Sustained sssssss. Task: Sustained zzzzzzz. Ability in conversational speaking to sustain adequate breath support, to help prevent laryngeal strain. (Optional Task: Reading or repeating graded length sentences.)

3. CHANNEL/VOCAL TRACT 3.a

3.b

3.c

3.d

3.e

3.f

4. PHONATION Observe in conversation, and Additional Task: Ask the speaker to intone a long vowel on eeeh, aaaah, or oooh. 4.a

Rough Quality.

4.b

Breathy Quality.

4.c

Creak Quality.

0

1

2

0

1

2

0

1

2

The Voice Skills Perceptual Profile

4.d

Phonatory Stamina: Ask the speaker to describe their vocal stamina through a day, evening, week or vocally demanding performance, and rate accordingly.

0

1

2

Other Comments (e.g. onset, thick/thin folds, aphonic whisper, aryepiglottic involvement, tremor, diplophonia, etc)

5. RESONANCE 5

Balance of Head/Oral/Chest resonant quality.

0

1

2

Option to comment on auditory impression of the focus of ‘oral placing’. Optional Task: Ask the speaker to hum on a long mid pitch mmmmm, and to tell you if they feel any tickle or tingle between the lips.

6. PITCH 6.a

6.b

6.c

Centre/Mean pitch: Rate on whether too high or low for age and gender. Range: Highest to lowest pitch. Task: Demonstrate and ask the speaker to produce a glide and siren on eeeeh, and to speak up a scale on ‘hey’. Variety of intonation patterns.

0

1

2

0

1

2

0

1

2

0

1

2

0

1

2

0

1

2

7. LOUDNESS 7.a

Overall loudness level.

7.b

Variety in loudness (including use of emphasis).

7.c

Power Source. Task: 3 ‘heys’ at 3 loudness levels, and calling, to assess whether breath support and/or throat constriction. (Optional Task: Demonstrate and ask speaker to crescendo on a long vowel, staying on one pitch.)

91

92 Voice Work: Art and Science in Changing Voices

8. ARTICULATION 8.a

Consonants.

8.b

Vowels.

8.c

Pace.

8.d

Pause.

8.e

Fluency.

8.f

Rhythm.

0

1

2

0

1

2

0

1

2

0

1

2

0

1

2

0

1

2

TOTAL VOICE SKILLS SCORE FOR 31 FEATURES: (Do not include the two ‘whole voice’ rating scores) Range (0–62) Total = ANY OTHER RELEVANT OBSERVATIONS OF THIS SPEAKER’S VOICE USE (Use of words or images, apparent confidence, emotional connection to text, etc)

RELEVANT VSPP ASPECTS FOR VOICE WORK

Personal details The words ‘voice issue’ are used because this assessment may be done on a range of clients with a range of different vocal challenges. If the client has had an ENT examination, the findings are recorded here. There is space in the bottom right corner of the box for any relevant reference number to be noted.

Recording the assessment Recording for the VSPP starts after the assessor has filled in the biographical details on the assessment form, and after any necessary formal permission has been given. The client’s own words about her voice are recorded, along with a conversation and often a reading passage. As the profile involves visual, tactile and auditory perceptions, it would ideally be filmed on a DVD recorder. Although speech and language therapy departments often have such equipment, training sessions with actors, singers and public speakers rarely take place in rooms with image recording equipment. In these cases a sound recording will provide

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valuable data for much that is relevant, but any of the sections that rely on vision need to be carefully noted at the time.

Whole voice ratings In line with the GRBAS overall rating the VSPP uses a 4-point scale for whole voice ratings, but also includes the client’s self-rating. As we have seen, ratings by the speaker and voice practitioner for the ‘whole voice’ sometimes show an interesting discrepancy.

The nature of the data inputs The VSPP form shows that perceptions come from five different inputs, with information gathered from questions, tasks and observations: 1. The assessor’s auditory perception of what is heard in conversational speech, and reading or performing, e.g. does this speaker’s tongue sound tense and limited in movement? 2. The assessor’s visual perception, e.g. ‘What can I see in the posture of this person?’ 3. The assessor’s touch perception as she manually feels the client’s shoulder, neck and extrinsic laryngeal muscles. 4. Self-rating by the speaker, e.g. ‘What is my level of throat and neck discomfort?’ 5. Specific tasks, e.g. the speaker is asked to make a glide up through his pitch range on an eeeeh sound, from lowest to highest note. Some tasks are optional; they provide more information but may not be appropriate in each case. Once practitioners are familiar with the scheme, they can also include their own choice of specific tasks under the relevant aspect headings, e.g. under Voice Skill 6 (pitch), a client concerned about his singing may be asked to sing three to four lines of a simple song.

The Voice Skills features The assessor then explores the different Voice Skills features. There is space on the left side of the VSPP protocol form for descriptive comments, with a 3-point rating scale on the right. Although a distinctive feature of something may be positive or negative, here a feature is defined as ‘when the specified aspect of voice is judged by the assessor as being a relevant and possibly negative contributing factor to the overall voice, which may indicate a direction for voice work’.

Descriptive comments The intention is to create a perceptual assessment tool that allows considerable flexibility. Practitioners are trained to acutely attend to a number of specifically defined aspects of

94 Voice Work: Art and Science in Changing Voices

voice, and to note any observations under the relevant headings, but they can use their own terms. There can be considerable variation in the words used. To use a real example: Three voice practitioners listened to a recording of a speaker. They all knew that under Feature 4.b (‘breathy’ phonation quality) they were listening to how the vocal folds were closing in terms of air escape. They unanimously rated this at level 2, and agreed that the speaker definitely needed practical work to reduce this aspect in her voice. However, the SLT wrote ‘marked breathy onset, almost aphonic at times’, the voice teacher wrote ‘devoiced’, whereas the singing teacher wrote ‘far too much wind, airy’. The words differ but they mean something to each describer, and will help that person to select his own exercises.

The VSPP training does, however, train users to be specific as to where they write their words, e.g. a term such as ‘throat strain’ should not appear under the phonation heading, because it refers to an aspect of laryngeal tension in the channel section. Similarly, the use of the word ‘hoarse’ is discouraged, because it has such a mêlée of contributors to its sound. That quality is likely to be breathy, rough, low pitched and a bit creaky, and usually has over-tight laryngeal muscles. The VSPP aims to use specific terms that will enlighten the understanding of vocal function and guide action.

Quantitative ratings The numerical ratings are: 0 = No significant features 1 = Mildly significant features 2 = Markedly significant features. A feature is rated ‘mildly significant’ if the assessor judges it to be clearly present but not necessarily or immediately needing practical work. We may see that a speaker has rather poor posture and rate this at a 1 level, but it may be typical of her age group or cultural style and does not need to be changed. The average pitch of a presenter’s speaking voice may be judged as mildly low for a woman of her age and size, but not significant enough to need practical work. A child with vocal nodules may have a mildly rough quality remaining at the end of voice therapy, but this is acceptable to child, parent and therapist. An actor may have a breathy phonation quality that we rate as 1 in her habitual personal voice quality; although she may have to reduce this to play a particular character, it can be quite acceptable in her own voice. If a feature is rated as 2 – ‘markedly significant’ – the implication is clear that the practitioner will need to work with the client on this aspect of voice. The Profile allows for individual aspect ratings that lead to the generation of a pragmatic total number. The word ‘pragmatic’ is used since although the total gives a useful impression of the whole voice, the nature of the ratings and parameters is so different that the number is unlikely to be statistically reliable enough for peer reviewed research. The range of the total score is 0–62. So far the following are suggestions from the informal data analysis of scores:

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95

• Scores between 0 and 20 are likely to be within ‘normal’ limits. Work might be needed on specific parameters essential for particular needs. • Scores between 20 and 30 are likely to suggest a voice with a problem or disorder that would benefit from practical voice work to improve quality, flexibility, strength or stamina. • Scores between 30 and 62 suggest a significantly troubled voice that is likely to be part of the voice disorder spectrum.

Interjudge reliability Interjudge reliability is recognised as being problematic in perceptual voice schemes (Webb et al 2004). Kreiman et al (1993) wrote of the need for reference voices as ‘fixed external standards’ or ‘explicitly anchored paradigms’ to avoid the fact that listeners tend to rate voice qualities by using personal internal standards. The VSPP training provides training in recognising and rating each voice aspect, so that there can be as much agreement as possible. Italics are used here because, although it appears that thorough training can enable different voice practitioners to approach agreement on the scoring (see below), voice teachers, singing teachers and therapists often have different criteria for deciding on the need for practical work. Two examples illustrate this point. The therapist often deals with very abnormal voice qualities, and may hear a speaker’s mild degree of roughness as being within a normal range of vocal qualities and needing no direct work. But the voice teacher may see this same level 1 of roughness as a potential problem for a young student actor who may need to play a demanding role in eight shows a week at a large provincial theatre. A classical singing teacher may worry about the relationship of this roughness to singing voice tone, but, if the client is a middle-aged rock singer, his teacher may be unconcerned. Unless the agreed ratings have been trained and agreed upon, these practitioners are likely to disagree as to whether they rate this same degree of roughness as a 0, 1 or 2. In the same way, both therapist and voice teacher may be unconcerned about a musical theatre singer’s habitual, very slightly backed and slightly tense, tongue-body setting. They may see this as part of the performer’s regional accent and rate it at 1, with no need for practical work. But the role of tongue-body position can be highly relevant for a singing teacher, who might rate that same speaker’s tongue setting at level 2. A small-scale study was designed to see whether a group of mixed voice practitioners would find the VSPP scheme to be useful to their work, and to investigate whether training could improve interjudge reliability in the numerical ratings (Shewell 2005). Thirteen voice practitioners (three voice teachers, one singing teacher, eight SLTs and one voice teacher/ SLT) completed a 2-day training in the VSPP. Two client videos were shown at the start of the course and two at the end. In each case one of the pair was a client who wanted to improve his or her vocal style in presentation, whereas the other was a client with a voice disorder. The practitioners were asked to describe and rate each client on all VSPP parameters. Their total scores were compared with those agreed by the author and another trained voice practitioner. Interjudge agreement was shown to improve with training, and suggests that there is potential for reasonable VSPP rating agreement among trained judges, but further investiga-

96 Voice Work: Art and Science in Changing Voices

tion is clearly indicated. The VSPP ratings may prove to be used so differently between different practitioners that interjudge reliability is high only between members of the same professional group.

Example 6.3 The VSPP: teacher example Pamela consulted me as a busy teacher who was very anxious about the ability of her voice to ‘keep going’. She was seriously worried that she would have to stop teaching, as she felt that there had been an overall deterioration during the year before she finally went to her doctor. Pamela had told him that her voice was ‘husky and strained’ much of the time and that she had smoked during her 20s, so her GP had immediately sent her for an ENT check, to rule out any possibility of cancer. She was relieved that he found nothing structural to explain her symptoms, but his report described a ‘very tight pattern of voicing’. An explanation of her voice disorder (muscle tension dysphonia) and a summary of the voice work are included at the end of Chapter 27.

The written comments on Box 6.5 describe Pamela’s voice at the first meeting only and show the areas of work that were needed. The numerical scores on the right show both the first and last session VSPP scores so that you can see the changes. The circled scores refer to the pre-voice therapy assessment and underlined scores to the final assessment. Pamela worked very hard on all voice care suggestions and voice exercises. She did not become a ‘perfect voicer’ and there are several aspects where she remained with a score of 1. However, these were not significant in their effect on the whole voice function, and the total score shows that she made a great improvement. Since then she has had no further voice problems in her teaching.

Box 6.5 Pamela: two VSPP scores VOICE SKILLS PERCEPTUAL PROFILE: DESCRIPTIVE AND QUANTITATIVE © Christina Shewell Name of client: Pamela

Voice Issue: Voice strain as teacher

Age/date of birth: 45 Date of assessment FIRST: June 2006 (figures marked with circle) SECOND: November 2006 (figures marked with underline) Comments relate to first assessment only. Assessor: CS

ENT findings: Muscle tension dysphonia (if relevant)

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Start recording the session from here. CLIENT’S OWN WORDS ABOUT VOICE (write down exactly what is said) Question: Can you describe the sound and feeling of your voice, and why you are here? ‘I started noticing a year ago that by the holidays, my voice was really getting creaky and strained and now it happens during a week, and often by Friday it’s actually gone. It fluctuates a lot. It really worries me because it affects my ability to teach.’ CONVERSATION, AND READING OR SPEAKING A TEXT Ask the client to tell you about something pleasant e.g. an interesting project, holiday or experience; offer brief comments or questions if you feel this will make the speaking more natural. Unless reading is a problem, ask the speaker to read a short passage; if assessing a performer, this may be an already learned text. Ask the speaker to rate his/her own voice, and then later add your own rating. WHOLE VOICE RATINGS 0 = No problems 1 = Slight Problems 2 = Moderate Problems 3 = Severe Problems (Circle relevant number) WHOLE VOICE: CLIENT’S PERCEPTION WHOLE VOICE: VOICE PRACTITIONER’S PERCEPTION

Pamela CS

0

1

c

3

0

b

2

3

VOICE SKILLS FEATURES OF VOICE DEFINITION OF A FEATURE: when the specified aspect of voice is judged by the assessor as being a relevant and possibly negative contributing factor to the overall voice, which may indicate a direction for voice work. NUMERICAL RATINGS 0 1 2

No Significant Features. Mildly Significant Features. Markedly Significant Features.

1. BODY 1.a

1.b

Posture/Movement: Observe and rate. Ask about musculoskeletal issues. Nothing extreme, but tendency to slump in sitting position, shoulders forward and head poking/extension. Says she always sits ‘off balance’ Shoulder, neck and extrinsic laryngeal muscle tension: Feel and rate. On palpation, tight shoulder and sternocleidomastoid muscles and lateral laryngeal movement resistance. Tight crico-thyroid visor, and around hyoid. Says there is slight tenderness when I feel her muscles.

0

1

c

0

1

c

98 Voice Work: Art and Science in Changing Voices

1.c

Vocal tract sensation: Speaker to rate on severity & frequency of discomfort. c 0 1 P. describes pain below larynx, and at sides and back of neck when tired. Throat feels ‘dry’. 1.d Overall physical/ emotional tension: Speaker to rate on 1–10 scale (0 = 0–4; 1 = 5–7; 2 = 8–10). b 0 2 Says she is generally fairly relaxed but ‘I find it hard to relax at the end of a day’s teaching’. Any other comments: (general health, past illness or accidents, exercise and fitness etc). Fit and generally well – goes to gym 2–3 times a week 2. BREATH 2.a

2.b

2.c

Placing: Observe in conversation, and Task: Ask client to count 1–10 five times, quickly and quite loudly. Upper chest, shallow pattern in talking and task, audible gasping and upper chest heaving! Control: 0 = 15 or more seconds; 1 = 8–14 seconds; 2 = 1–7 seconds. Task: Sustained sssssss. 16 seconds Task: Sustained zzzzzzz. 12 seconds Ability in conversational speaking to sustain adequate breath support, to help prevent laryngeal strain. (Optional Task: Reading or repeating graded length sentences.) Audible laryngeal/pharyngeal tightening at ends of sentences as appears to run out of breath – could not manage past number 6 of assessment sentences..

0

1

c

a

1

2

0

b

2

0

1

c

0

b

2

0

b

2

0

1

c

a

1

2

3. CHANNEL/VOCAL TRACT 3.a

3.b

3.c

3.d

Lips: Rate on range of movement and apparent tension, and describe the ‘setting’ tendency. Slightly narrow range of movement – not abnormal. Spread lip setting. Jaw: Rate on degree of open or close setting, and on apparent or described excess tension. Rather close setting – some suggestion of increased TMJ muscle tension. Tongue: Rate on the range of movement and apparent tension, and describe front/back and close/open settings. Minimized range of movement. Backed general setting – not a problem. Soft palate: Rate on adequacy of audible open/closure setting. Slightly increased head resonance suggests possibly ‘sluggish’ palate, but see resonance.

The Voice Skills Perceptual Profile

3.e

3.f

Pharyngeal Constriction: Rate on whether audible constriction. Slight constriction. Laryngeal: Rate on larynx position and laryngeal muscle tension/laxness. Listen for frequent audible inhalation. Audible constriction in talking, worse at high volume level, or when she runs short of breath support towards end of long sentences when there is lower SGAP (sub glottic air pressure).

0

b

2

0

1

c

99

4. PHONATION Observe in conversation, and Additional Task: Ask the speaker to intone a long vowel on eeeh, aaaah, or oooh. 4.a

Rough Quality. Definite roughness/harshness present. 4.b Breathy Quality. Slightly breathy quality. 4.c Creak Quality. Only slight at this first assessment, P says can be much worse. 4.d Phonatory Stamina: Ask the speaker to describe their vocal stamina through a day, evening, week or vocally demanding performance, and rate accordingly. Deteriorates during a teaching day, and through week, but also when out for evening. Other Comments (e.g. onset, thick/thin folds, aphonic whisper, involvement, tremor, diplophonia, etc)

0

1

c

0

b

2

0

1

c

0

1

c

aryepiglottic

5. RESONANCE 5

Balance of Head/Oral/Chest resonant quality. b 0 2 More nasal resonance than oral or chest – resonance sounds ‘thin’. Option to comment on auditory impression of the focus of ‘oral placing’. Optional Task: Ask the speaker to hum on a long mid pitch mmmmm, and to tell you if they feel any tickle or tingle between the lips. P’s voice gives impression of being ‘ held at the back of her mouth’; did not feel ‘lip tingle’. 6. PITCH 6.a

6.b

Centre/Mean pitch: Rate on whether too high or low for age and gender. Sounds appropriate in conversation, but P says it is lower than in past. Range: Highest to lowest pitch. Task: Demonstrate and ask the speaker to produce a glide and siren on eeeeh, and to speak up a scale on ‘hey’. Limited upper range on glide – P reports can no longer sing with children, and higher pitches are painful.

0

b

2

0

b

2

100 Voice Work: Art and Science in Changing Voices

6.c

Variety of intonation patterns. Limited pitch variety.

0

1

c

0

b

2

0

b

2

0

1

c

a

1

2

0

b

2

0

b

2

a

1

2

a

1

2

a

1

2

7. LOUDNESS 7.a 7.b 7.c

Overall loudness level. Low average level – says on phone is often asked to repeat things. Variety in loudness (including use of emphasis). Limited variety – ‘rather mono-loud’ quality. Power Source. Task: 3 ‘heys’ at 3 loudness levels, and calling, to assess whether breath support and/or throat constriction. (Optional Task: Demonstrate and ask speaker to crescendo on a long vowel, staying on one pitch.) Uses only laryngeal constriction not increased sub-glottic air pressure for volume increase. Ran out of breath on 11 in counting task.

8. ARTICULATION 8.a 8.b

8.c 8.d 8.e 8.f

Consonants. Fine Vowels. Vowels rather ‘muffled’ – lack carrying power because of lip/jaw Closeness, and possibly limited tongue range of movement. Pace. Quite fast. Pause. Appropriate. Fluency. Appropriate. Rhythm. Appropriate

TOTAL VOICE SKILLS SCORE FOR 31 FEATURES: TOTALS: June 2006 = 36 November 2006 (after 6 sessions) = 12

ANY OTHER RELEVANT OBSERVATIONS OF THIS SPEAKER’S VOICE USE (Use of words or images, apparent confidence, emotional connection to text, etc) FIRST VSPP: Pamela has little idea how to project her voice in a healthy and effective way at school, and simply tightens in the throat area. This is a major contributor to her voice problem.

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RELEVANT VSPP ASPECTS FOR VOICE WORK BODY Explanation of heat/friction and that if she talks for even 5 hours a day, her vocal folds open and close around 4,140,000 times a day! Relevance of hydration – recommendation of steam inhalation for two weeks and then at the end of any day her voice feels strained or tired. Physical active release sequence for shoulder/neck area to do at school + manual therapy (using my hands on tight sore throat muscles in gentle massage) + recommendation for osteopath check. BREATH Move breath placing to abdominal/middle chest, and work on building up length of sustained zzzz and longer sentences on one breath so no end of utterance ‘laryngeal grip’. CHANNEL Reduce throat clearing + increase lip and jaw movements, release tendency to jaw clenching, work on laryngeal deconstriction. Possibly increase lip and tongue range of movement for carrying power in classroom. PHONATION Reduce tendency to creak, work on getting her to feel thick fold/thin fold distinction. Work on power through coordinating adequate lower breath, and simultaneous voice onset. RESONANCE Bring oral resonance forward – so voice will carry better, and be less focused in the laryngeal/pharyngeal area. PITCH Work on pitch range for vocal fold flexibility, and wider vocal variety. Pamela wants to sing in class. LOUDNESS Work through the Voice Projection handout, to give her clear ideas on easy ‘power voice’.

Voice practitioners’ views on the application of the VSPP to their work Subjects in the pilot study (Shewell 2005) were asked to complete a questionnaire about the usefulness of the VSPP to their work, and the results were positive; 12/13 rated the VSPP as very useful as an assessment tool with clients and 11/13 rated it as very useful as a tool to plan training/therapy with clients. All 13 approved the use of both quantitative and qualitative sections in the VSPP, and intended continuing to use the scheme in the future and recommending it to other practitioners. Specific comments included: Singing teacher: ‘It enhanced my listening to the student’s speaking voice and made me think in more specific detail.’ Voice teacher 1: ‘It encourages you to commit to a judgment because the qualitative and quantitative sections encourage more reflection and analysis. It’s user friendly; the headings/parameters are clear and observe a basic progressions.’ Voice teacher 2: ‘As everything is interconnected, all eight headings are relevant and, as a general assessment, these allow for a consideration of issues that might not have occurred to me or to the client. I am now using it with clients, and I like that they themselves can get insights through the process. SLT: ‘I like the way it gives structure to my assessment, and more importantly my treatment planning. It has facilitated my process of working out which areas needed to be addressed, in what order and why. It really prompts the voice practitioner to assess specific areas and then draw this information together within a holistic framework.’

Later feedback from VSPP users continues to be positive.

102 Voice Work: Art and Science in Changing Voices

Practical voice work directions from the VSPP The specific listening needed for accurate perceptual analysis is hard work to learn and hard work to do. On training courses singing teachers, voice teachers and therapists struggle together to identify the significant sound changes in their own and others’ voices, but, once the analysis is done, the voice is better understood and the direction for work immediately becomes clearer. The decisions are then to do with how changes might be effected in the voice skills. Part 5 offers a range of possibilities for that action, in terms of practical suggestions and specific exercises. Before that, we look at the physical foundations of the eight core Voice Skills.

Part 4

Voice work foundations

Introduction Even though different voice practitioner groups will always vary in the detail of their knowledge base, all practical voice work should have an accurate foundation of basic vocal anatomy and function. Many excellent books, journals and an ever-increasing number of websites offer extensive material to inform and deepen our knowledge. This section does not attempt to replicate these texts. Instead, it selects key facts, findings and diagrams that I have found to be particularly relevant as an underpinning to my voice work and links them to a series of ‘practice statements’. These are not intended to provide a comprehensive list of all there is to say about each topic, nor to cover the intricate detail of structure and function that is made clear in other sources. They aim to use accessible language to communicate some core facts that can help voice practitioners feel competent to: 1. Carry out voice exercises with a basic understanding of structure and function. 2. Give accurate, user-friendly explanations about aspects of voice to individuals or groups. 3. Recognise when they might need to know more – and where to find that information. The practice statements are organised under the eight Voice Skills headings. The last chapter in this section is more discursive, since its topic is the links between emotions and voices, and how we can support the emotionally distressed client.

Voice foundations: Recommended texts (These are fully referenced at the end of the book.) Blandine Calais-Germain (2006). Anatomy of Breathing. Janice Chapman J. (2006). Singing and Teaching: A Holistic Approach to Classical Voice. Tom Harris, Sara Harris, John Rubin and David Howard (1998). The Voice Clinic Handbook.

Voice Work: Art and Science in Changing Voices. Christina Shewell © 2009 Christina Shewell. ISBN: 978-0-470-01992-4

104 Voice Work: Art and Science in Changing Voices Lesley Mathieson (2001) Greene and Mathieson’s The Voice and its Disorders. William M. Shearer (1979). Illustrated Speech Anatomy. Robert T. Sataloff (2005) Professional Voice: The Science and Art of Clinical Care. 3rd edition. Johan Sundberg (1987). The Science of the Singing Voice. Leon Thurman and Graham Welch (eds). (2000). Bodymind and Voice: Foundations of Voice Education.

Chapter 7

Bodywork foundations

Many things that affect the body often affect the voice. This chapter considers some of these under six headings: 1. 2. 3. 4. 5. 6.

Posture Tension Tiredness and fatigue Age changes Health and physical ability Environment.

Posture Actors and singers in training do extensive work on posture, tension balance and movement In the early months as voice teacher at a major London drama school, I watched a first year movement class. Teacher Trish Arnold watched the new students repeatedly walk across the diagonal of the studio space, and I asked her afterwards what she was looking at. She said: ‘I am watching the shape of their spines, their habitual head and neck alignment, the way their arms hang from their shoulders, the way they use their pelvis, the weight balance in their hips, the tension in their knees, the placing of their feet, the way they use their body when self-conscious, the way they stand before they walk when they are nervous, and afterwards when they are relaxed – and more.’ She went on to talk about the way that she would work during the 3 years that lay ahead, to change negative patterns and build up strength, balance and flexibility, so that the actor’s body could deal with any role and any demand. If we know what we are looking for, we can look at the posture of our clients to see if it is relevant to the voice. Posture, tension and movement are absolutely intertwined. If we have good posture, we are less likely to have unnecessary tension in our muscles. If we have

Voice Work: Art and Science in Changing Voices. Christina Shewell © 2009 Christina Shewell. ISBN: 978-0-470-01992-4

106 Voice Work: Art and Science in Changing Voices

too little tension in the muscles of our body, we may be slumped or twisted. If we are very anxious, our posture is likely to be stiff but if we run, dance, twist or shake we can restore a healthier tension balance.

Posture and alignment have slightly different references The word posture is usually used for the shape that our body takes in space, when standing, sitting, lying down and moving. The relationship of one body part to another within the body is often called alignment – a word that means ‘an arrangement in a line’. Although often used interchangeably, posture and alignment have different meanings. We may say that a person has poor posture as he slumps in a chair; we would be less likely to say that he had a poor alignment with the chair. But we might say ‘as he slumps, his head–neck alignment is dreadful’, and that relationship can be relevant for voice. There are other smaller body alignments that are relevant to voice; some are bony, like the relationship of the vertebrae to each other, and some involve soft tissue, such as a habitual tongue posture relative to the roof of the mouth.

The skeleton is the framework for musculoskeletal activity Posture affects the way that the bones and joints of the skeleton work with the muscles of the body. Our skeleton (Figure 7.1) is like the steel frame of a skyscraper, and is the support, protection and container for nerves, organs, muscles and connective tissue. As it is hidden, we generally take it for granted. The monks of the Tibetan Tashi Lhunpo monastery use a ritual dance called Dur Dak (Lords of the Cemetery) to celebrate our bones and acknowledge that, no matter how rich or successful, all our bones will one day crumble into dust. Although we may have seen diagrams similar to Figure 7.1 many times, such a diagram acts as a reminder of the intricacy of this bony network that we inhabit, and the absolute connection of the head, neck, spine, ribs, pelvis and limbs. Move one of those, and attached muscles will usually affect the position of others. That is why the musculoskeletal postural relationship is so important to the working efficiency of the vocal structures. When you curl up your spine and move the shoulders forward, the lungs become compressed. Our pelvis may feel a long way from our larynx but its tilted or twisted posture can affect breath and voice.

The spinal column of vertebrae is the central support for the whole body In her first book, Linklater (1976) had a whole chapter on the spine as the support for breath. She stressed that ‘the efficiency of the vocal apparatus depends upon the alignment of the body and the economy with which it functions. When the spine is out of alignment, its ability to support the body is diminished and muscles intended for other things must provide that support’.

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107

SKULL Cranial portion Facial portion PECTORAL (SHOULDER) GIRDLE Clavicle Scapula THORAX

VERTEBRAL COLUMN PELVIC (HIP) GIRDLE

Sternum Ribs UPPER LIMB (EXTREMITY) Humerus

VERTEBRAL COLUMN PELVIC (HIP) GIRDLE

Ulna Radius Carpals

Metacarpals Phalanges LOWER LIMB (EXTREMITY) Femur Patella

Tibia Fibula

(a)

Tarsals Metatarsals Phalanges

(b)

Figure 7.1 Diagram of skeleton: (a) anterior and (b) posterior views. (Reproduced with permission of John Wiley & Sons, Inc. from Tortora and Derrickson 2006, Figure 7.1, page 196.)

The bony adult spinal column is made up of 26 vertebrae (Figure 7.2). The bottom coccyx and sacrum are fused but the cervical, thoracic and lumbar vertebrae can all move, as there are discs of soft tissue between each of the vertebrae from C2 to the sacrum. These form strong joints, absorb shock and allow the various movements of the spinal column. Some readers will know how painful it can be if one of these moves out of position, as a ‘slipped disc’.

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ANTERIOR

POSTERIOR

Cervical curve (formed by 7 cervical vertebrae) 1 2 3 4 5 6 7 8 9 10 11 12 Intervertebral disc

Thoracic curve (formed by 12 thoracic vertebrae)

1 2 3

Intervertebral foramen

4

Lumbar curve (formed by 5 lumbar vertebrae)

5

Sacrum Sacral curve (formed by sacrum) Coccyx

Figure 7.2 The vertebrae of the spine: right lateral view showing four normal curves. (Reproduced with permission of John Wiley & Sons, Inc. from Tortora and Derrickson 2006, Figure 7.16, page 213.)

The vertebrae slide on each other as the back curves down When we ask a client to ‘drop over from the waist’, in what is a classic voice teacher’s exercise, the spinal column curves as the head moves downwards in front of the legs. The vertebrae slide and shift to allow that curvature. If there is a problem with the joints between them or with general muscle tension, that bend down may be painful or even cause damage. Voice practitioners always need to be aware of that in their instructions; clients should be warned only to go as far as is comfortable, and that they have to be responsible for their own backs if working on their own. There are certainly limitations to do with general health and age factors but a lack of flexibility may be a matter of use and fitness; many middleaged voice practitioners can drop down lower than their younger clients!

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Lying on our backs on the floor in the semi-supine position can ‘release’ the spine The image of the vertebrae releasing when we use the semi-supine position is based in anatomical fact. Tortora and Grabowski (2003) describe how, when compressed, the discs ‘fatten, broaden and bulge from their between vertebral positions’. In the supported supine position, when gravity no longer pushes one down on top of another, there is far less compression, and the spine can lengthen.

The spine should curve We can suggest that someone who is lying on her back on the floor can ‘sink down’ or ask a client to ‘lengthen up through a straight spine’ but we do need to recognise that the idea of a truly straight flat back is a myth. As we can see in Figure 7.3, the cervical and lumbar areas naturally curve out, and the thoracic and sacral areas curve in; the curves should not be too pronounced, but they should be there.

Our habitual sitting posture is relevant to the comfort and long-term wellbeing of our bodies In western society many people sit for long hours at their work. Habitual spinal sitting shapes can have short-term effects on comfort, breath and energy, and long-term effects on the musculoskeletal system itself. A simple diagram such as Figure 7.4 can be a talking point with a client and ‘tune him in’ to his own postural patterns.

We benefit from postural balance in both activity and rest At the Moscow State Circus, I watched a young man walk backwards along a taut wire 13 m above our tilted heads, holding a 3-m-long pole at right angles to his body. He was

Figure 7.3 The natural curves of the spine, seen in the semi-supine posture.

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Balanced

Sagged

Rigid

Laidback

Hunched

Perched

Figure 7.4 Some sitting postures.

blindfolded but able to make this walk because he found exactly the right posture and alignment for the task, with a perfect mix of the two great opposing forces of gravity and levity. I use this image in my own voice teaching, when I sometimes make the point that we need to be rooted, to feel the surface upon which we exist, but we also need to lengthen upwards towards the sky. Balanced posture can make us feel more balanced. In his survey of relaxation methods Hewitt (1982) pointed out that traditionally, in eastern religion and philosophy, poised posture is taught as a lynch-pin technique of spiritual and emotional practice. ‘Good body use is conducive to body–mind harmony, and a feeling of poised effortless living.’

Use affects function This is the basic principle of the Alexander technique (described in Chapter 17). Body use can affect vocal function. A few examples: if the head is dropped too far forward onto the chest, or tilted sideways to hold a phone between neck and ear, the structures and muscles of the larynx are constricted. If the tongue is pulled tightly back in the mouth, in speaking and in silence, the hyoid bone at the back of the throat may be pushed down to compress the space between the false and the true vocal folds. If a lecturer teaches with shoulders

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raised, his breath and neck muscles may tighten his voice. If a singer carries a heavy shoulder bag with one shoulder tensely raised to keep the bag from sliding down her arm, it may affect the shoulder and neck muscle relationship, which in turn affects the larynx. All of these patterns are part of normal life and our bodies are quite able to adjust, but, if they become habits, there can be long-term effects on the voice.

Perfect posture is a myth Although postural work may be part of voice work, we do not aim for some ideal postural perfection. Barlow (1973) reassured readers that a body can cope with an occasional or bizarre posture, if the person has an idea of a ‘postural norm to which [they] can return’, but he warns that ‘distortions become each person’s norm’. Houseman (2002) says ‘body work is not about creating one posture or one way of moving, it is about finding balance and ease, freedom and flexibility’. Moshe Feldenkrais (1990) wrote: ‘any posture is acceptable in itself so long as it does not conflict with the law of nature, which is that the skeletal structure should counteract the pull of gravity, leaving the muscles free for movement. If the muscles have to carry out the job of the skeleton, not only do they use energy needlessly, but they are prevented from carrying out their main function . . . of movement.’ This clearly points out why we attend to skeletal and joint postures as underpinning muscle function. At times most of us slump, stand asymmetrically, let our stomachs sag and our backs curve, sit cross-legged and use a vast range of other alignments that are part of ordinary living. If we have both conscious knowledge and experience of healthy ‘foundation postures’, we can both use them and teach them more easily. Chapter 18 includes exercises to explore these postures for standing, lying and sitting.

Head and neck alignment is relevant for voice Inspired by a line drawing in Barlow’s (1973) classic book on the Alexander technique, I sometimes use my hand and wrist to demonstrate the relevance of head and neck alignment to the larynx (Figure 7.5). We can also demonstrate the effect on the voice to a client by asking him to make a sustained aah, starting with his head in a neutral position and gradually tipping it backwards. As this happens, the extrinsic laryngeal muscles stretch and tighten and the vertebrae curve inwards, compressing the pharynx above the larynx. The resulting sound usually becomes increasingly strained and ‘narrow’. It is important to have common sense here, because the larynx is perfectly able to adapt to head and neck movements; the point is that head and neck postures do affect the larynx, and long-term neck postures can contribute to a voice problem. The relevance of postural muscles to the larynx is clearly described in a short paper written by an ear, nose and throat (ENT) surgeon, therapist and physiotherapist for the Journal of Singing. Rubin et al (2004) said: ‘the larynx is suspended from the base of the skull, not by direct bony attachment, but by a series of muscles and ligaments. It could, in one sense, be considered to be in the centre of a constant battleground between the deep

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(a)

(b)

(c)

Figure 7.5 Hand and wrist postures to demonstrate the effect of head and neck alignment on the larynx. My clenched fist represents the head, the join of the hand to the wrist represents the neck and you can see the two roughly drawn boxes depicting the thyroid and cricoid cartilages of the larynx. (a) Hand as neutral head–neck alignment; (b) hand as head tipped forward; (c) hand as head tipped back.

extensor and flexor groups of muscles in the neck and upper back.’ This image parallels my own explanation to clients that the larynx is at the centre of a ‘cross of tension’, i.e. the meeting point of our shoulders as they face the world and our upright body stance. On an imaginative level, it is also at the centre of that slender conduit of neck and throat where thoughts, desires and fears move between our brain and the length of our body.

Changing habitual posture is most easily done in partnership with a trainer Changing postural habits is always best explored in experiential work with an expert pair of eyes and hands as guide. We can frequently feel that we are doing one thing with body alignment, but catch sight of ourselves in a mirror with an unintentional contorted position. Until they become automatic, the body sensations of a new postural habit may feel awkward, because ‘the mechanoreceptors are responding to a new pattern of stretch and pressure, and this change from habitually poor posture feels abnormal at first’ (Bunch 1982). Harris and Pehrson’s (1993) small-scale project looked at the effects of collaboration between a therapist and an Alexander technique teacher in work with four clients with different voice disorders. All improved vocally, and the authors found that ‘an increased

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awareness of posture and muscle tension could affect not just their voice, but general sense of well-being’. They concluded that the Alexander technique ‘complements and consolidates essential changes needed to ensure long term gains from voice therapy’.

Tension Some muscle tension is healthy and necessary Tension refers to the physiological state of muscle fibres, which can vary in the degree to which they are contracted and tight, or longer and relaxed. ‘When we say that a muscle is tense we mean that it is contracting, that its fibres are shortened’ (Jacobsen 1929). Muscle tension is a vital part of body function and clearly essential for any activity. If we did not have a permanently appropriate tone in our neck and jaw muscles, our heads would tip forwards or backwards, and our jaws would drop open – as anyone who has fallen asleep on a train will have experienced. The fine muscles of the larynx need tension to create vocal fold closure and changes in length. The larger muscles of neck, shoulders and torso need a healthy tension to create the stability and ‘anchoring’ to support strong voicing. Ordinary speaking uses muscles in a state of some tension. Acting and singing often use high energy levels of refined tension. Complete muscle and emotional relaxation is neither likely nor appropriate in voicing; what is needed is muscle tension appropriate for the activity involved. I use the word ‘free’ or ‘released’ rather than ‘relaxed’, because the latter gives the impression of being floppy and heavy. We need to be ‘ready for action, alert but not tense’ and able to differentiate between necessary and unnecessary tension (Berry 1973).

‘Releasing excess tension’ is a more appropriate term than ‘relaxation’ in voice work Boone et al (2005) define relaxation as ‘a realistic responsiveness to the environment with a minimum of needless energy expended’. My explanations to clients talk about releasing excess tension or rebalancing tension. ‘Release’ implies conscious action and suggests a process of what I call ‘active undoing’. Similarly, the precision of words such as ‘over-tense’ or ‘very tense’ is preferable to the description of muscles as ‘tense’. Any muscle in the body can become inappropriately contracted and shortened, and this may occur as a response to emotional stress. People differ in where they ‘put their tension’; we may develop headaches, back pain, stomach or colon problems, leg and hip aches, and many other symptoms. Some focus their tension into their delicate voice muscles. There may be an organic weakness or disorder in that part of the body, but this need not be the case. What seems to happen is that the muscles of one body area develop a pattern of habitual over-tightening which may remain unnoticed until it causes a problem, by affecting function. Many people know very little about the effects of tight muscles and connective tissue on the voice, and are unaware of their habitual body tension patterns, or that it is possible to change this. Simple awareness exercises can show a client the reality of physical tension.

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Voice story: Marian Marian was a 35-year-old secretary whose voice did not return at all after a simple cold. She had gone through a long period of work stress, and it later emerged that she had a conflict about whether she should tell her husband that she could not cope with living with his parents any more. Although she had never experienced voice loss before, she told me that she regularly felt a sense of neck and throat discomfort towards the end of a week, and that her voice could feel quite strained. I found this interesting because she did not have to use her voice very much at work, since her prime duties were on the computer. When Marian arrived to see me, with a barely audible breathy voice, she whispered ‘I think the doctor thinks it’s all in my mind, that I’m just doing it on purpose’. Although it seemed possible that this was an example of sudden psychogenic voice loss (described in Chapter 27), I told her that with voice loss there is no such thing as ‘all in the mind’. Whatever the cause, it was clearly ‘mostly in the muscles’, and I explained and demonstrated, by touch and action, her very tense throat, neck, shoulder and upper back muscles. By the end of that first session, practical release work enabled Marian to access her ordinary spoken voice sound again. We then began to explore what emotions might have contributed to her tight muscles and voice loss, and she recognised the relevance of her work and family stress. Our work did not, however, end with the restoration of Marian’s voice. I was interested in her frequent end-of-week throat strain and general discomfort, and asked her some detailed questions about her posture at work. She sat on a hard plastic moulded chair with a concave back, and the computer was placed far back on her desk. She demonstrated her habitual posture, which was to slump downwards in her chair, collapse her head and neck alignment, and poke her head forward with chin out and up, in order to see the computer screen. She took no physical exercise and told me that she often woke up feeling stiff in the mornings. I wanted to minimise Marian’s general postural–physical stress, because this could be a precipitating fact in voice loss, and we discussed this. She repositioned her computer and her boss bought her a better ergonomically designed chair. I also gave her a simple sequence of back and shoulder stretches to do at the end of every morning and afternoon, and suggested that two or three times a week she should follow a simple release sequence at home. When I checked up on her progress 3 months later, she said that her voice had been fine and she felt ‘years younger’, with no morning stiffness or any neck or throat discomfort. She also commented that this made her feel better able to cope with her emotional stress.

If we are strained and worn with anxiety or simply exhausted with hard work, 15–20 minutes lying on the floor in the semi-supine position (described in Chapter 18) can be immensely releasing and rebalancing. But at other times, we may need to move – to take exercise or simply to stretch, wave our arms in the air and jump up and down while voicing a loud ‘aah’ or appropriate words.

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Unaccustomed imbalance in tension can affect the voice Voice story: Sam Sam was a hugely successful rock singer in his mid-40s. Self-taught in singing, he had never experienced vocal problems. I saw him because, although his spoken voice and vocal folds were normal, he could not reach the top notes in his pitch range and had lost what he called his usual ‘edgy energy’. The root cause of his voice problems lay in the fact that he had broken his wrist. In itself, this would seem a bizarre reason for a voice problem but as it had prevented him from taking his usual exercise for 7 weeks, it had imbalanced his general muscle tone and breath pattern.

Tiredness and fatigue General physical fatigue can negatively affect the voice In the voice of an exhausted friend, we may notice a range of vocal changes – perhaps an increased creaky or breathy quality, ‘dullness’ in the vocal resonance, and a deeper average pitch with a more restricted pitch range of intonations. These perceptual changes are created by behaviour such as a more slumped posture, shallower breath placing with less vigorous airflow, less use of the resonating spaces, and weaker muscle tone and movements of the vocal folds. For her doctoral thesis in 2007–8 Alison Bagnall, speech pathologist and founder of VoicecraftTM International, looked at how the voice changed with lack of sleep. I am grateful to her for permission to report on these as yet unpublished findings. Bagnall used 15 professional voice-using volunteers with an age range of 22–56 years as participants. In a laboratory, they were first allowed a normal sleep, before a 24-hour period of sleep deprivation and then a final stage of an 8-hour sleep. During their sleep-deprived hours they were allowed to watch videos, but were not allowed to take any caffeine or exercise. At certain points they were recorded reading a passage and producing other vocal tasks, and underwent a number of other tests. A month after their first sleep deprivation experience, they received a 4-day Voicecraft training session. They then returned for a second sleep-deprivation experience, identical to the first. Eight volunteer listener–judges were thoroughly trained in listening for phonatory changes, including the degree of vocal roughness and ‘brilliance’ in the voice, that particular resonance quality that helps a voice to carry well. They rated all the voices on carefully designed scales. Statistical analysis of the results showed that sleep deprivation lowered the mean pitch level, increased the vocal roughness and reduced the ‘brilliance’ of the voice. All these effects were greatly lessened at the second recording, after the specialised voice training.

Good voice training can help to ameliorate the effects of tiredness on the voice This study provides important evidence of what voice practitioners have long known, that general tiredness and lack of sleep has a detrimental effect on the voice. As Bagnall writes

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‘these factors reduce the efficiency of the voice as a communication tool’. The findings also point out the benefits of a good sleep before a demanding vocal task, and provide firm evidence that good voice training can enable tired voice users to function better than they would otherwise be able to do. Actors and singers have to learn how to sound good when exhausted and stressed, and voice quality is essential for other professions such as teachers, politicians, air traffic control workers and the emergency telephone services, all of whom can experience high levels of exhaustion. Their need for vocal preservation and clarity under all conditions is one reason why voice teachers become involved with training such groups.

In specific ‘vocal fatigue’, aspects of voice deteriorate even if the speaker is not generally tired The term ‘vocal fatigue’ refers specifically to deterioration in the quality of phonation over time, with a loss of vocal stamina and the risk of an extra increase in effort. It can be a significant problem for any professional voice user who has to use his voice long and hard. Vocal fatigue is not simply a psychological sensation but a physical reality. McCabe and Titze (2002) describe typical vocal fatigue symptoms such as upper body and throat tension, sensations of throat dryness, lowered pitch and reduced loudness, together with changes in the phonation quality. These symptoms are likely to be caused by biomechanical changes (e.g. changes in blood flow, increased heat and vocal fold swelling, stiffness and ‘stickiness’ of the mucus covering), together with neuromuscular chemical changes. The authors describe how often, in classic ‘vocal strain’, the lateral cricoarytenoid muscles over-work to hold the vocal folds very tightly closed. This pressure may be great enough to swivel ‘the tips of the vocal processes’ outwards, so bowing the folds. The speaker feels or hears the increased breathiness that results, and tries to reduce this by closing her vocal folds even harder, so perpetuating the cycle. In fact, if she could allow the cricothyroid muscles to stretch and lengthen the folds a little, letting her pitch rise very slightly, the bowing would reduce and the excess tightening could reduce – a practical example of ‘pitch not push’. Such research offers us important insights into the physiological processes that actually happen in the tired voice, and this increased understanding helps us to plan the best possible techniques for voice protection in training.

Age changes We know that our voices are sculpted and painted by our emotional and cultural experiences, but throughout life they are also crucially shaped by the biological changes of physical development. This section provides a selection of facts relevant to voice practitioners. Mathieson (2001) and Sataloff (2005) provide detailed accounts of developmental changes.

The infant Voice practitioners often cite the penetrating, carrying cry of the yelling infant as an example of the efficient use of a small body as a strong sounding machine. Small babies’ ribs have

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little movement compared with adults, and they take frequent breaths – around 87/minute to the adult’s 12–16. The pitch of a baby’s voice is very high since the vocal folds are so tiny (around 3 mm in the average size newborn). The larynx lies at the level of the third cervical vertebra (C3), much higher than the adult level. The high larynx means that the infant can breathe and suck at the same time – something not possible for adults. Although lacking the variety of the older child’s voice, the baby nevertheless expresses a range of moods in his preverbal voice, and many of these primal sound qualities remain as archaeological strands in our own emotional utterances. The cry of a tired, uncomfortable baby often has a lot of nasal resonance, with a repeated falling intonation pattern, and traces of that can be heard in the voice of an adult complaint. The hard phonation quality typical of angry shouting has its roots in the tight vocal folds of the desperate fury of the hungry baby, whereas the breathy, open vocal fold cooings of the infant’s complete comfort and security can be heard in the soft, romantic tones of our own ‘sweet nothings’.

Young childhood At 18–24 months, the larynx moves down the vocal tract. By the age of 6, it reaches the adult position between C4 and C7 vertebrae, with vocal fold length of around 6 mm. In this new position there is a wider range of sound qualities because there is more resonating space in the pharynx above the vocal folds. The lungs have grown, so prolonged voicing and louder volumes are both possible, but the cartilages are still softer than the adult’s, and are not yet a robust supporting mechanism for sustained loud voice use. As the child grows bigger, so do all the structures relevant for voice.

Adolescence (I am grateful to singing teacher Jenevora Williams for specialist information about this age group’s voice; personal communication, 2007.) The hormonal changes and increased growth in various parts of the body can start to happen any time between the ages of 10 and 15, and are generally earlier in girls. In a number of different countries around the world the onset of puberty is increasingly early. There is no clear agreement as to the reason, but theories include better nutrition, increased artificial light levels, increased hormones in drinking water and the amount of psychosexual stimulation. In both boys and girls the overall larynx and vocal fold size increase, but this is more marked in boys, whose folds may quite quickly double in length, whereas the process of change is generally more gradual in girls. Sometimes a boy may unknowingly continue to hold his larynx in a high position with forward tilted thyroid cartilage, so stretching the vocal folds. There may then be a particular moment when there is a sudden release of tension and larynx position, and the deeper voice emerges. A post-pubertal teenage girl’s vocal folds may be 17 mm long, whereas those of a boy may reach 23 mm, with a much more prominent ‘Adam’s apple’ as the thyroid cartilage sticks out within the neck. As longer folds create

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deeper pitch, the male voice is clearly usually deeper than the female one, but the perceived pitch is also lower in a boy’s voice because of the larger resonators. Williams reports that the average speech frequency generally settles at 3–4 semi-tones above the lowest comfortable singing note, and this can be a guide for where an adolescent boy can sing. She says that boys can continue to sing during pubertal changes but there needs to be respect for what the boy might be feeling, and limitations in repertoire and exercises, e.g. most boys of 15 have a singing pitch range of only an octave, so rather than adult pitch range repertoire, Williams recommends one-octave range songs; rugby and football songs generally fall into this group but should be sung only with good technique! A boy chorister required to continue singing as a soprano may well use a pattern of overtightening and a high larynx as an unconscious compensation for vocal unpredictability, and this should never be encouraged by a choral director. At one of Williams’ workshops a young 16-year-old boy was still singing alto in his choir. He was obviously struggling and kept clearing his throat as he tried to sing, but when her exercises enabled him to let go, he produced a fine two-octave tenor range. His choral director said that he planned to make sure that the boy’s voice would be allowed to drop 5 months later; Williams emphasised that this was not good for the boy or his voice, and that he must immediately be allowed to release into the deeper voice.

Mature adulthood Unless affected by health or emotions, the voice of the healthy mature adult is relatively physiologically stable. However, for some women, the hormonal changes that occur in the 4–5 days before menstruation can have negative effects on the voice. Abitbol et al (1999) estimate that a third of women experience vocal fatigue, loss of power, and decreased pitch range and quality around the time of menstruation. Some singers try to avoid professional performance during this time, but Abitbol et al report that their prescriptions for multivitamins and certain medications enabled 84 of 97 women to experience vocal improvement. Changes to the female voice can also happen around the time of the menopause, but are by no means inevitable.

Voice story: Caroline Caroline was a successful 55-year-old folk/jazz singer who started our first session by saying ‘I know you’re going to say that I’m just getting too old to do this anymore’. I assured her that I never make so categorical a statement. Although she had been through the menopause, the cause of her vocal disturbance was a marked spoken-voice muscle tension dysphonia, connected to a period of general ill health and stress. Once that improved, so did her singing voice. Now in her 60s, although her general energy levels for touring are clearly less than they were, and she has slightly adapted her repertoire of songs, she continues to perform regularly around the world. The menopause need not be the end of life – vocal or otherwise!

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Old age Musculoskeletal, respiratory, neurological, cardiovascular and hormonal changes of the ageing body can cause a range of vocal deterioration. Among many specific examples, Mathieson (2001) reports that, at 75 years of age, respiratory efficiency is half that of a 30 year old. In most adults over the age of 65, most bodies are less mobile and stiffer, and there are likely to be shallower breath patterns, and features of increased roughness, breathiness and creak. The mean pitch lowers throughout life, but may rise in the 80s and 90s, and the fine pitch control, so important for singing, becomes harder. If vocal deterioration is severe enough to interfere with communication or with a desired specific voice use, such as singing in a choir, it may be diagnosed as a voice disorder and given the name ‘presbyphonia’. Shakespeare’s As You Like It description of the elderly man’s voice is well known: ‘his big manly voice, Turning again toward childish treble, pipes and whistles in his sound.’ But such deterioration in vocal quality is not inevitable. Miller (1986) gives the example of how dancer Martha Graham’s body never looked like that of a ‘typical old lady’, and there are many elderly speakers and singers whose voices are strong, fine and flexible. Provided that they have good enough health, physical fitness, nutrition and emotional attitude, older speakers need not experience Shakespeare’s vocal weakening. Performers can continue to stay vocally fit with a good use of all relevant voice skills. The old adage of ‘it ain’t what you got, it’s the way that you blow it’ is very apposite here, and voice practitioners have a role in maximising the voices of motivated elderly people who want to work on their voices. Most voice professionals would feel that healthy practical voice work would be preferable to the ‘voice lift’ reported by the press in 2004. This was a laryngeal surgical procedure carried out in the USA with the aim of taking the tremor or breathy quality out of an older voice. An eminent American surgeon was reported as having pointed out that the effects of a $US15 000 facelift were minimised if a person still sounded frail and old, and that vocal fold surgery to bring the folds closer together could be an important cosmetic surgery adjunct.

Voice story: Norman Norman was a 75-year-old retired garage owner who was active as a semi-professional jazz singer with a popular local ‘swing band’, with an average two or three pub gigs a week. Following a heavy cold and cough, he continued to perform but found that his singing voice suddenly seemed to crack in the middle of his practice, and he then lost control of his higher notes. He was sent to me with a diagnosis of ‘no specific vocal fold pathology – presbyphonia’. Norman sadly told me that he assumed that the time had come to ‘throw in the towel’. He was in good general health, and the sound of his speaking voice was normal except that he had a pattern of audible laryngeal constriction towards the end of long sentences as he appeared to run out of breath and his voice became what he called ‘an old boy’s croak’. When I asked him to glide up and down his pitch range and then to sing a few lines of a higher song, I noticed that he had little

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lower breath support and retracted his head and neck as he pushed up on higher notes. The focus of our sessions of voice work included posture change and tension release, abdominal breath support and vocal fold flexibility work to thin and stretch the folds for the higher notes. I also encouraged him to greatly increase his water intake and do some steam inhaling. After six sessions there had been a huge improvement, but he also adapted his repertoire to sing lower by a tone. Three years later, he continues to perform.

Health and physical ability There are many diseases, medical conditions and drugs that can affect the voice If a client tells you that they have a particular health problem, it is worth investigating whether there could be any effects on his voice. Internet search engines make this relatively easy, and the core texts about voice disorders can also be illuminating. The effect of both medical and illegal drugs on the voice is a huge area. Harris et al (1998) offer a wide-ranging description of the effects of drugs on the voice, and the use of drugs in treating voice problems. Sataloff (2005) describes the effects and side effects of medications for professional voice users.

Physical disability need be no bar to voice work Voice work can almost always be tailor-made to the individual need. As with any speaker, even when disability restricts movement and voice there are often additional habitual patterns overlying organic difficulty. The aim is to maximise the freedom of any voice. Vocal change can usually happen regardless of body shape or ability, if there is sufficient energy and motivation. The professional theatre company Graeae, whose company are all disabled, have voices that can carry and move their audience in the same way as any other theatre company.

Environment The environment in which we live and work can affect the health and sound of a speaker’s voice Home environment Tradition has it that we are more likely to open up our bodies and breathe in rural environments with clean air and long views, than in cramped polluted urban atmospheres. Some dialect coaches link the intonation and energy of particular accent to the landscape in which a speaker is brought up, contrasting the lilting rise and fall of mountain dwellers’ speech patterns with the flatter or tighter tones of residents of the plains or cities. There have been

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no large-scale studies into these ideas. Mathieson (2001) describes research published by Multinovic in 1994. This found that many more 12- and 13-year-old children who lived in an urban environment had voice problems (43.67%) as opposed to those living in rural areas (3.92%). This is a hugely significant difference, and raises interesting questions because, although it may be linked to high levels of pollution in some cities, there may well be other factors.

Our work environment People’s homes may be relatively clean, quiet and stress free, but their working conditions may be very different. Fume inhalation, contact with toxic chemicals, noise levels, particular body positions needed, long or loud hours of heavy vocal use, all are work-based conditions that may affect the voice. The voice practitioner may even find herself involved in liaison with employers or even legal cases.

Our auditory environment Unless we have a hearing impairment, the language that we speak is learnt through our ears. Our vocabulary, grammar, accents and aspects of voice are shaped by the auditory landscape in which we grow. When actors have to learn a new accent for a particular role, they may have a dialect coach and will practise with appropriate audio recordings, but a visit to the relevant geographical area is invaluable. Here the actor is surrounded by the accent’s ‘auditory atmosphere’, including landscape, music and history, along with speakers’ body postures, tension levels and overall sound. As described in Chapter 16, the noise levels of some workplaces can be damaging to both the hearing and the voices of those who work there. Even in a family setting, levels of noise and communicative intensity may have an effect on a child’s voice. One 7-year-old client was the youngest of five children and habitually spoke at a very high loudness level to make himself heard. As the smallest in the family of seven, there was an additional postural issue, in that he tended to tip his head backwards to look up at his parents and siblings, thus adding to the strain on his laryngeal muscles.

Our emotional environment As adults we recognise that our voices change in response to your moods and reactions to others. If a child grows up in an atmosphere of tension, fear or anger, there may be longterm effects on the habitual muscle tension of the body, and these may be relevant for the voice. The effects of emotions on the voice are described in Chapter 15.

Chapter 8

Breath work foundations

The Voice Skills approach is unequivocal in that attention to breath is a core foundation for voice work. I always look at a client’s breath placing and control, and can then decide if breath work is relevant for any reason. Breath has an intimate connection to our emotions and general bodily wellbeing. It is no coincidence that the word ‘inspiration’ has both physical and emotional meanings; our lungs expand so that air can enter our bodies, and our minds expand when a new idea or insight drops in. Sometimes deliberately letting breath come deep into our bodies seems to help us absorb a new idea or access a new energy; conversely, blowing out a few long breaths on a strong fff sound can help the psychological and physical release of a strong or disturbing emotion. There is a two-way connection between lungs and larynx, because breathing affects phonation and laryngeal behaviour affects breathing patterns. As described at the end of the chapter, some practitioners believe breath work to be unnecessary if the laryngeal or postural settings are maximally efficient. The client’s breath and laryngeal settings are two sides of the coin; both are needed for the value of the currency. Voice work can go in at either place, but, in my own work, attention to breath will generally be the first part of the equation.

Breathing for different purposes There are at least five types of breathing for different activities Although our breathing remains primarily under the automatic control of the brain’s breathing centre, we can adapt it to our needs and activities.

Normal non-effortful breathing without voice With a fairly still body position, for most people this is typically around 8–16 breaths/ minute. There may be an equal length for exhaling and inhaling, or we may naturally take longer to breathe out than to breathe in.

Voice Work: Art and Science in Changing Voices. Christina Shewell © 2009 Christina Shewell. ISBN: 978-0-470-01992-4

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Breathing for exercise The depth and frequency of breath will be affected by the level of the activity – contrast the breath in slow swimming in a peaceful lake, lifting a heavy weight, dancing flamenco or running away from a grizzly bear.

Breath holding for effort If we have to exert a strong effort, as in lifting, pushing, childbirth or forced defecation, we may take relatively few breaths and the breath will be held behind tightly closed vocal folds, so that pressure can build up within the body to push against resistance. Sometimes this forceful breath-holding is not necessary and exercise coaches may advise students to let the breath release as they lift, stretch or make other physical effort. Clients with tensionbased voice problems should be discouraged from weight lifting or other exercise that might create forceful vocal fold closure.

Breathing for conversational speech We speak on the out-breath, so inhalation is much quicker than exhalation. The frequency and number of breaths are shaped by what is said: quick shallow breaths for short utterances and longer, deeper breaths for lengthy sentences. Unless nervous, we rarely plan to breathe. It is an everyday miracle that we start to speak our thoughts with no conscious plan of the exact words that we are going to say, or of how long our sentence will be. We often discover what we think or feel by speaking. It is therefore important that we have adequate control so that the breath can adjust to anything that we say, spontaneous conversation or learned lines, at soft or high loudness. Voice teacher Patsy Rodenburg refers to this as the breath being ‘organic with the thought’ (personal communication, 1987). It is rarely helpful to tell clients to ‘breathe more often’ when speaking, because most forget this instruction as the content and emotional relationship of a communication take over. Deliberate conscious inspiration is helpful for certain voice disorders, such as speakers who have a paralysed vocal fold with lots of air escape. For most speakers, the aim is to ensure that they have an automatic organic breathing pattern that can cope with short and long utterances at any volume level.

Breathing for singing Sung phrases are often long, strong and variable in pitch, with very precise vocal tract adjustments. As a singer learns a song, he may work out where to breathe, marking it on the manuscript and consciously controlling it. Of course it is then necessary to make this as seamless as possible so that it sounds quite natural, and most singers do need excellent breath–voice coordination. Many singers and actors do not realise, however, that their ordinary day-to-day breath patterns may be relevant to the performing voice.

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The respiratory system Core parts of the respiratory system (Figure 8.1) are the breathing centre in the brain, the nose and mouth, the pharynx, trachea, lungs, ribs and breathing muscles.

The brain’s breathing centre is the medulla oblongata at the base of the brain stem This has the central control of breathing, and regulates a number of reflex (automatic) responses including breathing, blood pressure and heart rate, as part of the autonomic nervous system. That is why conscious control of breathing can only ever go so far, because ‘breathing is an organic and spontaneous process. Exercises are not intended to submit it to strict control, but to correct any anomalies whilst retaining its spontaneity’ (Grotowski 1975).

Nose Nasal cavity Oral cavity Pharynx Larynx Trachea

Right primary bronchus Lungs

Figure 8.1 The respiratory system: structures of the respiratory system – anterior view. (Reproduced with permission of John Wiley & Sons, Inc. from Tortora and Derrickson 2006, Figure 23.1, page 848.)

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We can breathe through our noses or mouths in voicing Some clients ask which they should use when breathing, and of course the answer depends on our activity level. It is true that nose breathing allows the lining of the nasal passages to filter and moisten the air, and that continual mouth breathing can dry the mouth and throat, so silent breathing should generally happen via the nose. But when talking or singing, all of us tend to let the breath come quickly into our mouths, and it would be a huge waste of time if we were to shut the mouth each time at the end of each sentence in order to breathe through the nose.

The pharynx is the tube that runs from back of the nose down to the top of larynx and oesophagus As the pharynx is lined with mucous membranes that need to be kept moist, the pharynx needs good hydration levels. Although one continuous tube it is often considered in three sections: 1. The nasopharynx (top part): a passageway for air 2. The oropharynx (middle section): a passageway for air and food 3. The laryngopharynx or hypopharynx (bottom section): a passageway for air and food. The epiglottis is a cartilage that acts like a trap door to close off the entrance to the larynx when we are swallowing. Most people will know the extreme discomfort and uncontrollable coughing when it does not close properly and a small bit of food or fluid ‘goes down the wrong way’.

The larynx has a vital role as a protective valve for the lungs The larynx and vocal folds are hugely important as a valve to protect our lungs from the inhalation of any food or liquid. In human evolution, it is generally believed that this became adapted as a voluntary vibratory source for communication only later.

The trachea runs from the larynx to the start of the main bronchial tubes If you look at images of the vocal folds in Chapter 3, the dark tunnel below the vocal folds is the start of the trachea. A typical length of an adult trachea is around 10–16 cm, and the inner diameter about 20–25 mm. Showing students those measurements with a ruler usually elicits a response that the tube is shorter and wider than expected. As the only conduit for oxygen into the lungs it needs to be wide enough to be that prime supporter of life.

The lungs are two air sacs for regular exchange of oxygen (O2) and carbon dioxide (CO2) which sustains our lives The trachea splits into two main bronchi and these then branch into multiple breathing tubes within the two lungs, similar to the ever-smaller branches and twigs of a tree, until

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they become a network of tiny alveoli within the lungs. Respiratory physician John Costello (2007) says that there are 300 million alveoli, which are extensive enough to cover a tennis court if they could be spread out! The lungs can expand in three dimensions – up, sideways and downwards, with most movement possible as the diaphragm moves downwards. Voice exercises sometimes include instructions to ‘breathe to the bottom of your lungs, and then empty them’, but we never actually empty our lungs. I often suggest an image of three functional areas. The bottom part keeps some residual air (around 1.5 litres in healthy adults) for our safety if we are winded or temporarily unable to breathe, but air in the middle and upper thirds can move in and out as the person breathes. A ‘shallow upper chest’ breath pattern tends to use the top part only. Various aspects of breathing can be examined and measured, including airflow, air volume and chest wall movements; these are described in Baken and Orlikoff (2000).

The ribs protect the lungs and expand as we breathe The 12 pairs of curved ribs form a strong cage to protect the lungs and the other organs that lie in the chest (thoracic) cavity. All the ribs may move as we breathe, but in voice exercises we generally place our hands to curve around the lowest, as these have the most scope for movement, and we can feel this more easily.

There are many breathing muscles, with more muscles active for inspiration than for expiration Table 8.1 shows the large number of muscles involved in breathing. Few voice practitioners need to know all the names, but the list demonstrates just how complex is this spontaneous activity of which we are mostly so unaware. It is important to note that the sternocleidomastoid is not an extrinsic laryngeal muscle. It may be seen to bulge in strenuous speech or singing, as a result of musculoskeletal tension or high lung pressure, but strictly speaking it is not part of the voice mechanism (Jacob Lieberman, personal communication, 2008).

Summary of the action of the main breathing areas Breathing in When we breathe in, the diaphragm tightens and moves down, pulling with it the elastic tissue of the lungs. At the same time, the ribcage expands sideways, forwards and slightly up. There is then more space within the chest so the lungs expand and outside air moves in. As the diaphragm moves down, the abdominal area is pushed out slightly. That outward movement is a result of breathing in, not a cause, as our stomachs do not swell out in order to take in breath.

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Table 8.1 The main breathing muscles and their actions.

Name of muscle

Where it may be felt

What it does when active

—

—

External oblique Internal oblique Rectus abdominis

Side of abdomen Side of abdomen Runs down centre of abdomen Deep in abdomen Between ribs Mid and lower back Lower back

Expiration When the four abdominal muscles contract, they push the abdominal content inwards thus forcing the diaphragm upwards. They also pull on the ribs, so decreasing the ribcage cavity and expelling air from the lungs Pull ribs down so abdomen pushed forward Pull ribs down so abdomen pushed forward Pull ribs down so abdomen pushed forward

Transversus abdominis Internal intercostals Serratus posterior inferior Quadratus lumborum Diaphragm External intercostals

Latissimus dorsi Levator costarum Serratus posterior superior Accessory breathing muscles

Under base of ribcage, vaulted upwards Between ribs

Whole side of back Between ribs and vertebrae — —

Stenocleidomastoid

Neck

Pectoralis major Pectoralis minor Serratus anterior Scalenes Levator scapulae Trapezius Rhomboideus

Upper arm to sternum Shoulder to ribs Side of ribs Neck Neck and shoulder Upper back Upper back

Contracts abdominal cavity Pull all ribs down Pull ribs down at back Pulls the twelfth rib down at back Inspiration Pushes abdominal cavity down and out Raise all ribs The back muscles may also be involved in deeper inspiration All raise ribs at back

— If the accessory muscles below are too active, we are likely to see an ‘upper chest’ pattern of breathing Supports head and raises sternum and collar bone Raise ribs at front Raise ribs at front Raise ribs at front Raise ribs at side Elevates shoulders Elevates shoulders Retracts shoulders

Breathing out When we breathe out silently, with no voice, the diaphragm relaxes upwards. At the same time the ribs move inwards and downwards, pulled down by the internal intercostal muscles, and the elastic tissue of the lungs relaxes inwards. In breathing for voice, the abdominal muscles and even some lower back muscles may contract, so further encouraging the diaphragm’s upward movement and controlled airflow out of the lungs.

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Five moving areas in breathing Many voice practitioners talk about the movements of five main areas when they work with clients: the abdominal (or stomach) muscles, diaphragm, ribs, back and upper chest.

The abdominal area The abdominal muscles move during breathing The contraction of the abdominal muscles creates a pressure that helps to push the diaphragm into the chest cavity on the out-breath. If these muscles ‘support’ the breath, they can ‘support’ the voice, as the stream of air then powers the vocal fold vibration without extra tension in the laryngeal muscles. As you can see in Figure 8.2, there are four core

Sternum Clavicle Scapula Second rib

Deltoid Pectoralis major

Serratus anterior

Latissimus dorsi Serratus anterior Biceps brachii RECTUS ABDOMINIS (covered by anterior layer of rectus sheath) Linea alba EXTERNAL OBLIQUE Aponeurosis of external oblique Anterior superior iliac spine

EXTERNAL OBLIQUE (cut) Tendinous intersections RECTUS ABDOMINIS TRANSVERSUS ABDOMINIS Aponeurosis of internal oblique (cut) INTERNAL OBLIQUE Inguinal ligament

Inguinal ligament

Aponeurosis of external oblique (cut)

Superficial inguinal ring Pubic tubercle of pubis

Spermatic cord (b) Anterior superficial view

(c) Anterior deep view

Figure 8.2 The muscles of the abdominal wall. (Reproduced with permission of John Wiley & Sons, Inc. from Tortora and Derrickson 2006, Figure 11.10, page 352.)

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abdominal muscles; all may contract in strong voiced expiration, but their individual involvement will vary according to the person and the vocal task. They do not all move inwards. Kayes (2004) advises singers to ‘keep your awareness on the following when vocalising: the navel moves inwards and the waistband moves laterally’. We may feel this if we make several strong vvv sounds, with one hand placed at the side of the waist, thumb pointing backwards and fingers forwards, and the other hand just over the navel. After each vvv, all we need do is to let go and the breath ‘drops in’. We do not need to work on the in-breath because, with the right out-breath mechanics, it will take care of itself. Practitioners sometimes use phrases such as ‘breathe with your stomach muscles’ or ‘let your hand rest on your stomach’. In general public parlance the word stomach is used to refer to anywhere at the lower front of the torso between breasts and pubis, though the stomach actually lies under the ribs, slightly on the left of the body above the waist. I refer to ‘central’, ‘lower’ or ‘abdominal’ breathing with adults, and ‘tummy’ breathing with children. Any of these terms is fine, so long as your client knows that you are referring to the lower not the upper area. It is sometimes impossible to be anatomically precise, and none of us wants to have to instruct someone to ‘place your hand on the material of your trousers that covers the skin that lies over your colon’!

The tranversus abdominis muscle plays a role in body stability and breath A steady, continuous tension of the deepest abdominal muscle, tranversus abdominis (TA), is recommended for musculoskeletal health and is central to Pilates’ ‘core stability’. Its tone is also relevant for vocal stamina and power, because it has physical connections with part of the diaphragm. Some practitioners believe that it should be constantly ‘switched on’ for voicing, whereas others suggest that it should release when the breath ‘drops in’. Physiotherapist Rachael Lowe says that, as the TA muscle shares some innervation with the pelvic floor muscles, you can feel its contraction if you deliberately contract those deep muscles (personal communication, 2007). Its action can be felt in these ways: 1. Place two fingers on one hipbone, and then move them an inch down and an inch in towards the centre of your abdomen. Deliberately contract your pelvic floor muscles, and you may be able to feel a slight movement outwards under your fingers; that is the TA muscle contracting. 2. Kneel on all fours and let the abdomen ‘drop’, as you let the breath drop into your body. As you deliberately contract your abdominal muscles to blow out a steady stream of air, you may be able to identify a deep muscle contraction. This is likely to be the TA muscle, although the rectus abdominis and oblique muscles at the sides of the body will also come in.

Ultrasound can allow us to see the action of the abdominal muscles in real life Physiotherapists Ed Blake and Jane Grey have developed the use of ultrasound to view breathing muscles in action at their London clinic, where they specialise in the assessment and treatment of performers with physical or vocal complaints. In a painless and non-

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invasive procedure, the physiotherapist passes an ultrasound probe over the skin of a client’s abdomen as she speaks or sings. The different abdominal muscles can be seen on a computer monitor, appearing like archaeological layers (Figure 8.4). As they ‘fire’ to increase subglottic air pressure during voicing, they can actually be seen contracting. When a client is lying down and silent, the three layers are thin and relaxed, but during exertion or strong voicing the muscles can be see to thicken. Usually we encourage clients to use the pressure of their hands as feedback, along with any inner sensations. This ultrasound technique of imaging the muscles can be used as a visual cue to the client as to how to use the muscle action as he voices, and the physiotherapist can give instant feedback and suggestions. ‘During performance phonation, any variation from the normal sequence of muscular contraction may be identified and corrected’ (Blake, personal communication, 2007).

Abdominal muscle work will not make a client look fatter Many clients are embarrassed by extra weight round the middle of their bodies or value their flat stomachs for work and social life. They are self-conscious if they feel that they have to ‘swell up’ or ‘be like a balloon full of air’, because all suggest a growth outward that is usually unwelcome. I always explain that abdominal breath work involves an active muscle movement inwards from the habitual resting position as the breath flows out, and then a release and return to that original resting position as the breath drops in again. There need not be any ballooning outwards and in ordinary life the movements are subtle and hardly noticeable; they should become a natural part of the psychophysical functioning of the body. The amount of movement in the ribs and abdominal area varies between activities, and we may be able to see larger breath expansion when watching singers or actors in demanding live performances. I watched Opera Factory’s production of Ligeti’s ‘Nouvelles Adventures’ with fascination because I could easily observe the singers’ breathing, as they were naked for part of the show!

Intense abdominal muscle exercises may tone a client’s shape but are inappropriate for voice work Abdominal muscle involvement in voice is not about intensive effort, but about the efficient coordination of the muscles. Some clients ask if they should work hard to deliberately do ‘stomach pull-ins’ to tone their bodies and improve their voices. This is not a good idea for voice. As Blake says ‘excess contraction can create the reaction of bracing in the upper spine muscles. This in turn can lead to chronic contraction of the cervical spine, causing suprahyoid muscle tension and reduced laryngeal mobility’ (personal communication, 2007).

Some people need to work on breath through release, not deliberate effort Deliberate active abdominal muscle work is part of much voice work, and a cornerstone of methods such as the Accent Method (Kotby et al 1993). This uses a structured programme

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of rhythmically controlled abdominal breaths, and is widely used in the treatment of voice disorders. However, it is important to recognise that for some people conscious breathing exercises are not appropriate. They need an experience of space and time in which to let go, to allow their feelings and bodies to release, so that the breath can ‘drop in’. Work with singing, movement, imagination or text can shape the breath with little or no need for deliberate technical exercises.

The diaphragm The diaphragm changes shape as we breathe The diaphragm is often described as a sheet or shelf of muscle. Sundberg (1987) uses the image that when contracted down in inspiration it is shaped like a plate, and like an upside down salad bowl when it relaxes upwards as we breathe out. The diaphragm is a large muscle that separates the chest cavity from the abdominal cavity, and that close link to the abdomen explains why performers will find it harder to control breath and voice after a large meal. At the back it attaches to the spine, and at the front it is joined to the bottom of the sternum (the breast bone) and to the lower parts of the ribs. These attachments again show us why skeletal posture can be so relevant to efficient breath and voice function. Many people are unaware of the considerable size of the diaphragm, or its large movements within the body. These can be shown to clients in an excellent 6-minute video available through the Voice Care Network UK for use in educational purposes. This uses a cleverly sequenced series of still X-rays, in which the shape and action of the diaphragm during singing can clearly be seen. It also provides excellent ‘in action’ images of the vocal folds and the side of the vocal tract.

We can have little direct sensation of our diaphragms ‘working’ Clients sometimes think that they can deliberately practise moving the diaphragm, and actors and singers may say that they have a ‘lazy’ diaphragm. We can easily sense and move our abdominal and back muscles but, as the diaphragm is ‘incapable of providing sensation regarding its precise movements or its position within the torso’ (Miller 1986), it is much harder to consciously control its movements. There is interesting dissent from McGuire (2000), whose work has had considerable success with those who stammer. He believes that there are two parts of the diaphragm and, although we have no conscious control over what he terms the main ‘crural’ part, we can have voluntary control of the remaining small ‘costal’ area. The general agreement is that ‘diaphragm work’ can happen only as a result of consciously activating other muscles. This may happen in the quick panting exercises often used by voice teachers, or when we use steady abdominal muscle movement to control the rise of the diaphragm in a long sustained vowel. Irregular diaphragm movements may cause voice

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instability in emotional tension or distress. Violent hiccoughs are an extreme example of uncontrolled diaphragm movements, as the diaphragm jerks in spasms, leading sometimes to wild voicing on the in-breath. Understanding diaphragm movements can be confusing for clients, who may assume that, if they feel the stomach muscles release as they sense the breath ‘dropping in’, the diaphragm must also be relaxing, and vice versa. Short notes like these can help understanding: Breath in – the diaphragm actively contracts downwards, and in reaction the stomach area moves down and outwards. Ribs move up and out. Breath out – the diaphragm relaxes upwards, the ribs drop down and inwards again and the abdomen moves inwards.

Diaphragm movements can be complex Our understanding of breathing muscle action continues to develop. Although the diaphragm relaxes when we breathe out, Thurman and Welch (2000) describe how, in the trained singing voice, the diaphragm can ‘co-contract’ as it relaxes upwards, to act as a kind of check on that abdominal muscle movement. This extra subtle diaphragm tightening can be very efficient for singing and strong spoken voice.

The ribs The ribcage expands during breathing As the breath enters the body, the external intercostal muscles pull the ribs upwards and outwards to create more space for the lungs to expand sideways and to the front. The movements of the ribcage are affected by a number of different muscles. More movement is possible in the lower ribs than in the upper, and Heman-Ackah points out that the top lobes of the lungs are more difficult to expand than the lower, so that a ‘greater degree of airflow, and thus the voice, can be achieved with abdominal breathing than with chest breathing alone’ (conference presentation, 2007).

People vary as to whether they use more rib movement or abdominal movement in habitual breathing patterns Some people naturally breathe with more abdominal movement, and some have more obvious rib expansion. This cannot reliably be related universally to gender, age or other factors, but Thurman and Welch (2000) report on Hoit and Hixon’s findings of the link to body type. This suggests that thin ectomorphic people tend to use more rib action, the larger endomorphic individual favours an abdominal breath pattern whereas the middle-build person uses a combination of the two. Whether or not you begin to notice these tendencies, it is sensible to notice which pattern is predominant in a particular client, and incorporate that insight into voice work on breathing.

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Ribcage expansion is relevant for voice Even if voice work focuses on establishing a solid pattern of abdominal movement in breath, rib involvement should never be ignored, because this is important for voice in speaking, and particularly in the fine control needed for singing. Hoit (1995) writes that ‘the advantage of an expanded rib cage for speaking is that the rib cage muscles are elongated and their capacity for generating rapid pressure changes is improved’. Welch and Sundberg (2002) write that classical singers ‘seem to use their rib cage mainly for changing lung volume, though some singers appear also to make use of the abdominal wall’. Kiesgen (2002) described the effective singing lessons that he took with Giorgio Tozzi, who ‘stressed the need for a steady flow of the breath, but suggested greater rib expansion when singing high notes’. ‘Rib reserve’ used to be taught to actors as a desirable breathing method. This required the speaker to deliberately lift and hold his ribcage expanded for long periods while he used the abdominal muscles for active breathing. The theory was that a reservoir of breath was then held within the chest. Voice teacher Margaret Braund reports that, if taught well, it did not lead to a stiff-chested declamatory style, but it was often taught badly by drama teachers, even to children in schools (personal communication, 2007). Actors sometimes believed that they were supposed to keep their ribcage raised for long periods. One elderly actor told me: ‘I inflated myself just before I came on at the start of Hamlet, and kept it all up and out until the end, when I let it collapse in the wings. Quelle relief!’ I occasionally demonstrate rib reserve as a tune-in to the action of the ribs, and the control that we can have over different breathing muscles. Some acting courses teach it and some do not; it can be useful in high-energy speech, but needs to be taught and used selectively and well. Watching an actor play Titus Andronicus, Canadian voice teacher Ann Skinner commented ‘I think he’s using too much rib reserve. He seems to be fixing the diaphragm, and the ribs swing out, and then he has a huge amount of breath no matter what he says, instead of the thought impulse coming from the centre’. The movement of the ribs during breathing may also be relevant for musculoskeletal balance. When treated by an osteopath some years ago for a minor back problem, his advice was that, as a predominantly ‘abdominal breather’, increased expansion of my ribcage would help restore balance to the spine.

The back Some back muscles are involved in breathing Table 8.1 shows that some back muscles lift the ribs in inspiration, and others in the lower back pull the ribs down to help expiration. Much of the back movement felt in deep breath is due to the ribs moving outwards during inspiration. That is why it may feel as if a speaker is ‘breathing into the back’ if we place our hands at the sides of his back. I often place my hands on clients’ backs in breathing work, as that part of the body is usually fairly emotionally neutral to touch. Most clients can then use the biofeedback of a practitioner’s hand pressure to locate and work their lower back movement. The back muscles do not have a major role in controlling the flow and rhythm of breath but they give support to the diaphragm, abdominal and intercostal muscles, and the stable posture of the body. Back muscle work is relevant for the voice that needs to carry far and

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long, or indeed for the disordered voice. Many singing and voice teachers use exercises designed to encourage students to connect to these muscles. Speech and language therapists working with neurological problems may incorporate awareness of this area if there are problems in diaphragm movements, but a focus on the back breathing sensation is less often used in voice therapy.

The upper chest A lower ‘central’ breathing pattern is generally better for strong healthy voice use rather than ‘upper chest’ breathing alone The ribcage can also be lifted upwards by the accessory breathing muscles in the neck, shoulders, and upper chest and back, and Figure 8.3 shows four of these. We generally call

LEVATOR SCAPULAE LEVATOR SCAPULAE 4 5

TRAPEZIUS

6 7 1 2

PECTORALIS MINOR

Sternum

3

SERRATUS ANTERIOR

4 SERRATUS ANTERIOR

5 6

6 External intercostals Internal intercostals

7

7

8

8

9

9 10

10 (a)

Rectus abdominis (cut)

(b)

Figure 8.3 Muscles that move the shoulder girdle; some are accessory muscles of breathing: (a) anterior deep view; (b) anterior deeper view. (Reproduced with permission of John Wiley & Sons, Inc. from Tortora and Derrickson 2006, Figure 11.14.)

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this ‘upper chest breathing’ because that is what we observe when the client takes a breath. Such a pattern is an important available option because it can be an extra help to inspiration in extreme exercise and various medical conditions, where frequent quick shallow breaths may be essential. If a client uses those accessory muscles too much, lower breath work may be needed. The use of the italics emphasises that, as air moves through the upper part of the lungs, most of us have slight movement of the upper chest in breathing – and some more than others. But a habitual use of those accessory muscles may increase a tendency to excess tension in the vocal tract, neck and shoulder muscles, particularly during loud or high voice use (Figure 8.4). If we are using only the top part of the lungs, we may run out of breath towards the end of a sentence or when tired or under stress. The air pressure under the vocal folds (the subglottic air pressure) then drops, and we are more likely to squeeze with the laryngeal muscles. If we do not have enough breath, the voice becomes thinner and less varied in resonance, pitch and volume. The deliberate use of the accessory breathing muscles may be necessary with clients whose diaphragm is paralysed or who have a serious chest problem such as emphysema. Interestingly the main focus of the Buteyko breathing method for helping asthma involves the upper chest area.

Fascia between muscle layers

Contents of peritoneal cavity

External oblique Skin/subcutaneous fat

Tranversus abdominis

Internal oblique

Figure 8.4 Ultrasound scan of three layers of abdominal muscles, taken as client was speaking. (Reproduced with the permission of Ed Blake.)

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Breath placing We can see or feel the focus of activity in a client’s breathing pattern I use the word ‘placing’ with clients to refer to the part of the body that they can feel moving during inspiration and expiration, which will be one or more of those five areas described above. The instruction to ‘place’ the breath allows sensory information to connect the speaker or singer to the relevant muscle movement in motor exercises. If we ask a client to breathe into his back, the client may feel it and we may see it. If we place our own hands there to check for movement, we too may feel it, and know that the appropriate muscles and movements are being activated.

Naming a specific muscle can aid sensory awareness With selected clients, we may occasionally identify specific muscles, because naming a muscle can aid awareness. This may be to explore positive use, as in ‘try to feel the internal contraction of the deep TA muscle as you intone that long note’. Or it may point out a negative pattern: ‘If you place your hands on the sternocleidomastoid muscles at the side of your neck, you may feel how much they tighten as you get louder.’

Images are useful in breath work, but practitioners also need to know the anatomical reality The essence of my breath work approach is to enable clients to feel, identify and become aware of their breath patterns, and then to offer thoughts, actions and images to use in exploring options for breath placing and coordination with voice. After that, the client can gradually incorporate new awareness and change in his own time. Images in breath work can be very useful; they can heighten a sensation to increase awareness and, as we saw in Chapter 2, activating the imagination can have physiological effects. Practitioners can hold the paradox that the instruction to ‘imagine the in-breath comes up from the ground, circles up the front of your body, over your head and then the breath flows out and down your back in an easy stream’ has no literal reality, but it may enable students to connect deep into body and breath awareness. We do, however, have a responsibility to know that breath enters and leaves the lungs, and only the lungs, as misleading statements are not uncommon and can confuse clients. In his otherwise useful book Gut Instinct, Pallardy (2006) writes that until they are 2 years of age children ‘fill their lungs and abdomen with air’, and that if it ‘does not get enough oxygen, the abdomen becomes sluggish and underperforms’.

Ask a client to breathe out first and then to ‘let’ the breath come in Nervous speakers are sometimes told to ‘take a deep breath’ by well-meaning outsiders, but pulling an extra bit of breath into possibly already inflated lungs is likely to increase tension

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and do little to improve the breathing pattern. In work on both voice and anxiety control, it is better to say ‘blow a long breath out and let the breath drop in low (rather than deep) into your body’. The image of ‘long out and low in’ helps get the right actions, and work should always start with expiration. Voice is placed on the out-breath, the egressive airstream and, if we get that working in the best possible way, the in-breath will look after itself. If we empty our lungs by blowing out all possible air and try not to let breath in, most of us only manage a few seconds. The body wants to breathe. The brain’s breathing centre instructs our airways to open and the breathing muscles to work. Gravity and the lungs’ elasticity do the rest, so that the breath rushes in on a gasp. Unless we have breathing difficulties, we should not have to ‘suck’ or ‘pull’ the air into the lungs, because its movement is regulated by the brain and pressure changes within the lungs.

Starting with big breathing muscle movements is easiest for a client When we start work with a client to shape his breath pattern in some way, we may ‘tune in’ to the muscles by using large, obvious, deliberate movements. But it is reassuring and realistic to make it clear that within minutes those movements can be fine and barely visible, as they should be in ordinary life. I often place my hands on my body to demonstrate the subtle abdominal movements as I chat, and point out that, when the client first met me, he was presumably not surprised by any obvious movements as I breathed.

Breathing work is part of many complementary medical practices, stress management and body training In Germany since the 1930s, a small professional group of breath therapists have used imagery and physiological exercises in their work with a range of physical and emotional problems. Although in the UK many people could benefit from breath work to help them manage the effects of stress, it is not easy to find suitable practitioners. Physiotherapists are the professional group most involved in such work, but the voice practitioner may well find himself ‘doing breath work’ for reasons other than voice, with an anxious public speaker, a stressed singer or a client with a voice disorder. If someone is emotionally distressed, deeply blowing out a breath may help the release of a tensely held body, and I tell acting students they can always ‘blow it all out’ if an imaginative exercise connects them to upsetting emotions.

Breath control We need enough breath pressure under our vocal folds to maintain the voice that we want When we use voice, a high enough subglottic (under-fold) air pressure is needed to push against the vocal folds and set them vibrating, and this is partly created by the controlled use of the muscles of expiration. ‘The longer the available air lasts, the more that can be

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said or sung on one breath. Here is the essential secret of breath control for speaking and singing: to achieve prolonged phonic expiration through proper muscular coordination’ (Luchsinger 1965). Falstaff’s words in Henry IV, part 2 point this out: ‘is not your voice broken, your wind short?’ If you blow all possible air out of you, you will be able to quickly count from one to ten, as you will still have some residual air left in your lungs. However, you will almost certainly hear laryngeal constriction as you try to ‘squeeze’ out voice. In this exercise you are demonstrating what happens when you have very low subglottic air pressure.

The term ‘breath support’ implies adequate subglottic air pressure The term ‘breath support’ has long been a part of voice work vocabulary. There does seem to be an agreement that it exists, but a definition of its meaning is contentious. As Sand and Sundberg (2005) say ‘its exact physical correlates have not yet been accurately identified’. They investigated whether experts in the sung voice could identify ‘good’ or ‘bad’ singing voice support in 42 recordings of voice exercises sung with varying degrees of support, and found that the term support ‘seemed to mean similar things to different experts’. My own view is that the core factors relevant to ‘good support’ are a mixture of postural, breath, channel and laryngeal behaviours, and that the breath aspect involves both placing and control.

Breath control is not about holding the breath In the summer of 2007, a newspaper article reported that a 30-year-old German had set a new world record for holding his breath under water. Having inhaled pure oxygen for 20 minutes, Tom Sietas held his breath for an incredible 15 minutes and 2 seconds. A lung expert reported that his lungs were 20% larger than average for a man of his size, and that he kept absolutely immobile under the water. He will also undoubtedly have trained over a long period of time. Similar advanced breath achievements have long been known in the meditation practices of highly trained yogi. The breath needs to flow in and out for voice to be produced, and we need a good coordination of expiration with voice. There is no advantage in such extreme feats of breathing and, as breath-holding usually requires tightly closed vocal folds, it should not be used as a voice exercise, unless with the specific aim of strengthening a weak vocal fold closure.

Breath can be measured A typical tidal volume (the amount of air inspired and expired) of a quietly resting adult is around 0.5 litre; a suitable plastic water bottle will give you an idea of how much air moves in and out. Obviously, this amount varies according to our emotions and our activity, as we will need more oxygen to feed our muscles and organs. Our vital capacity is the amount of air that we can breathe out after the deepest possible inspiration, bearing in mind that

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there is always residual air left at the bottom of the lungs. This can vary greatly, even in healthy people. Mathieson (2001) quotes figures for healthy women as between 1.4 and 5.6 litres, whereas that of men is slightly larger at between 2.0 and 6.6 litres. In our conversational speech we do not use all this breath, only generally moving around 25% in and out. Nevertheless, that whole vital capacity is available to us in strong or sustained voicing, and can be accessed by singers and actors.

Prolonging a sound and counting aloud on one breath can give some indication of breath control The air in our lungs can quickly rush out or move out slowly. For a loud short sound we may use a great deal of air, but in longer utterances we need to be able to ‘hang on’ to some of that air, so that we do not get into a pattern of creaky laryngeal constriction. If we ask someone to make a voiceless or voiced sound last as long as possible on one breath, it can tell us something about that person’s breath control – his ability to let the breath flow out fairly slowly, rather than letting it all ‘rush out at once’. Using a watch or clock that shows seconds, we can ask the client to prolong a voiced zzz or vowel sound for as long as possible on one out-breath, and record the maximum number of seconds. A client can have two or three attempts at this, and the best is noted. Colton and Casper (1990) report on the norms for this ‘maximum phonation duration’ (Table 8.2). Many voice practitioners use sustained voice tasks. Age, gender, general health, fitness and current emotional state affect the length of an intoned sound, and writers generally agree that any average measure gives only a rough idea of breath control. Boone (1991) suggests that if adults cannot typically hold a long sss sound for 15–20 seconds, they may need direct breath control work. He also says men should be able to count out loud for 12 seconds on one breath, and women for 10 seconds. Although these simple tasks give an informal indication of a speaker’s breath control, we must relate this to other tasks. Some speakers have low scores but excellent breath control in singing; others have high scores but marked patterns of laryngeal constriction when speaking long sentences. Patterns in body use, channel and phonation must also be taken into account because they too will be relevant. My experience is that many speakers with muscle tension voice disorders, and speakers who complain that they run out of breath, do often have shorter than average sound dura-

Table 8.2 Table of maximum phonation duration.

Male Female

Young child, 3–4 years (s)

Older child, 5–12 years (s)

Adult, 13–65 (s)

Older person, >65 years (s)

8.95 7.50

17.74 14.97

25.89 21.34

14.68 13.55

Adapted from Colton and Casper (1990).

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tion times. There can be some interesting surprises, even with trained performers, who should have higher than average sustained sound competencies. One internationally successful bass–baritone singer in vocal difficulties collapsed after 10–12 seconds of the sustained sounds in all three attempts. He recognised that he had let himself become both over-weight and under-fit, but was shocked at how shallow his ‘ordinary life’ breath control had become. Undertaking a strong regimen of general physical and vocal exercise allowed him to return to his previous vocal power.

The S : Z ratio looks at the relationship between the length of voiceless and voiced prolonged sounds The client is asked to produce a long-as-possible soft zzz (Z) sound and sss (S). They are accurately timed with a stopwatch, and a mathematical ratio is obtained by dividing the maximum S length by the maximum Z time. The theory says that both sounds should last around the same time, and this shows that the vocal folds are valving (controlling) the airflow effectively. So, if my S and Z sounds are both 20 seconds, my ratio is 1. If, however, my S lasts for 24 seconds, but my Z for only 13, my ratio is 1.84 – suggesting that there is air wastage as I voice and the vocal folds are not vibrating efficiently. Eckel and Boone (1981) found that clients with dysphonia caused by an actual laryngeal pathology tended to have normal voiceless expiration times (the long S) and markedly shorter phonation times (the long Z). However, studies suggest that the ratio is not effective at distinguishing between children with a voice disorder and those with healthy voice (Colton and Casper 1990). I do not use the ratio but do sometimes compare the two sounds. Sometimes the Z is longer than the S; this tends to occur in speakers with relatively good breath control but a tendency to over-tighten in the laryngeal area. That ‘grip’ allows the vibrating folds to control the breath outflow on the voiced sound, whereas the long S flows out more quickly through the open folds. We also need to listen to our clients in ‘real-speech’ tasks, including reading or repeating sentences of varying length and conversing in connected speech. We can then observe where they have to take a new in-breath, or start to strain as they run out of breath, and we can see what other voice skills may be relevant to those patterns.

Body position can affect the breath pattern Much voice therapy takes place with clients seated, whereas singing teachers generally use the standing position. In theatre voice training, students may explore their voices in a variety of positions and in both movement and stillness. Actors and singers may find themselves vocalising in some very odd positions; demands on my clients have included the need to sing while roller-skating, speak poetry while hanging upside down from a trapeze and deliver long, strong emotional prose while buried up to the neck in silver sand. The ‘lying on the back’ position is often used in voice development work. Speech science offers some interesting views on this practice. Sundberg et al (1991) point out that gravity

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is one of the main factors that influences subglottic air pressure, and that this varies according to the body position. When we are in an upright position, our abdominal content is located below the diaphragm, and the weight of the former tends to pull the latter downwards. So when standing, gravity is a helpful inhalatory force. By contrast, when lying down, gravity pushes the abdominal content (and therefore the diaphragm) into the chest cavity, and so is an exhalatory force.

Voice story: Curtis Mayfield Curtis Mayfield had a successful 30-year career as soul singer, until in 1991 he was paralysed from the neck down after a lighting rig fell on him during a performance. It seemed unlikely that he would be able to sing again as his diaphragm was no longer working properly. However, 6 years later his new vocal album ‘New World Order’ was released to excellent reviews. In a newspaper interview with journalist Adam Sweeting (1997) he said: ‘prior to my accident I had a diaphragm and my lungs were strong, and I could stand up and belt it out and get into the tune. The difference now is that I don’t have a diaphragm and my lungs are quite weak. So I’ve found a way to lie back in my chair to give my lungs a little help from gravity.’

The semi-supine position can be useful for connecting to abdominal movement during the out-breath Hoit (1995) describes how changes in body position create alterations in the relationships of muscles, cartilages, tendons and connective tissue, and in the elastic recoil forces of the lungs and chest wall. She does not support the use of the supine position in clinical voice practice, and says there is no natural carry-over in the mechanism into upright. She writes ‘the motions of the abdomen are noticeably large during supine resting tidal breathing, particularly when contrasted with those during upright resting tidal breathing’. I regularly use the semi-supine position with appropriate clients because these abdominal movements are more obviously happening, and can be used to focus the client who has trouble connecting to lower breathing when upright. Gravity moves the diaphragm ‘headward’ (Hoit 1995) as the client breathes out and he can feel this. We can point out what is happening and suggest direct deliberate contraction of the abdominal muscles, moving on to link this to voice. Lying down often allows reflection and awareness so that breathing practice can be explored in that introspective and usually relaxed position. If the body is given the chance to learn a new pattern in quiet stillness, with the right support it can be carried over into the upright normal speaking position. Of course this is important; we clearly mostly converse when sitting, standing or moving. In my own practice, if breath and voice have been explored in the semi-supine position on the couch or floor, no client ever leaves without experiencing those same exercises in sitting, standing and walking postures. Immediately and always after semi-supine work,

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I ask the client to get up, stretch and shake, to change the position, sensation and mood, and we then consciously work to recapture that lower support in the more ordinary phonatory postures.

People may feel dizzy when starting work on their breathing This can happen in any age group. People may suddenly find that they feel slightly lightheaded, dizzy or ‘spacey’, and in extreme cases may actually faint. It can happen in deep breathing, or if frequent shallow breaths are taken as in a panting exercise. This can occasionally be the beginning of hyperventilation, and the voice practitioner must be aware of this. Most doctors agree that true hyperventilation can happen when a person uses a pattern of rapid breaths. This is often associated with stress of some sort; the person is not aware that she is breathing too fast, the stress creates a panic breath pattern, which in turn makes the person feel more panicked – and the cycle continues. Turner and Hough (1993) describe how victims of torture sometimes use acute hyperventilation as a strategy in order to help dissociation from the pain. This breathing pattern can later recur each time that the terrible memories are accessed. It may become a chronic habit, particularly if the person has other stresses such as life in a new country, the loss of her previous society, and uncertainties over her refugee status and separation from her family.

Hyperventilation has to do with the changed balance of O2 and CO2 Normally our lungs take oxygen from the air, and breathe out the excess CO2 produced by the cells of the body. However, we do need adequate levels of CO2 in the blood and, if we breathe faster and/or deeper than necessary, its concentration in the blood may drop below normal, causing constriction of the blood vessels in the brain. This reduced blood flow can cause a range of symptoms including light-headedness, numbness, headache, chest pain and fainting. There can also be changes in the acidity of the blood and cerebrospinal fluid, which surrounds the brain and spinal cord; if this becomes too alkaline it can cause a range of bodily symptoms.

The practitioner may need to take steps to deal with a client with signs of possible hyperventilation If a client feels light-headed or dizzy, it is important to stop any exercise that you may be doing and make sure that she is sitting down. It may help to put the head down on the knees to encourage an increased blood flow to the brain. Try to take the focus off breathing, but, if the client feels panicked, tell her to place a hand on the lower breathing area, and to slowly blow out very quietly and slowly, letting just a very short shallow breath ‘drop in’ at the end of each out-breath. The old-fashioned advice of breathing into a paper bag can restore the right O2–CO2 balance in the body as the person starts to breathe in the CO2 that she has just breathed out. But having a bag over the face does little to help

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psychological stress or change long-term habits, and these always need to be addressed. If a client regularly hyperventilates, she may need training and support from a specialist physiotherapist.

Two final thoughts The need for direct work on breath in voice work is a contentious issue Although my approach places a high emphasis on attention to breath, voice philosophies and methods remain varied and some practitioners question the primacy of practical breath in changing voices. American voice teacher, Bonnie Raphael (1994), stated ‘I now teach breathing with increased awareness of laryngeal dynamics. . . . I deal with an isometric balance between force and resistance in the larynx and allow breathing to adjust accordingly’. Frederick Husler has influenced many singing teachers, and his belief has been that if what he calls ‘the suspensor mechanism’ in the throat is adequately set for singing, it will bring in the appropriate respiratory muscle action ‘which is crucial for easy register balance’ (Husler and Rodd-Marling 1976). In the early teaching of American singing voice specialist Jo Estill, it was suggested that breath work was not needed if the basic ‘figures’ or settings of the laryngeal area worked well. Some Alexander technique teachers believe that, as the impairment of ‘primary control’ negatively affects the larynx, the breath sorts itself out if the head–neck alignment is right.

We need a healthy common sense in our approach to how clients breathe Unless we have a particular problem, we do not need to consciously control our ordinary breathing, and speakers have a range of normal breathing patterns. All voice practitioner groups generally discourage breathing with the upper chest accessory breathing muscles alone, but we need to be careful about any assumption that this pattern is ‘wrong’ and will automatically lead to some sort of voice strain or limitation. This is simply not true; watch any group of informal talkers or formal presenters and you will see a variety of upper chest movement patterns, and rarely a vocal problem. It is not that upper chest breathing alone causes a voice problem; rather establishing lower breathing can be an important part of the restoration of a damaged voice or the building of a stronger one. If a client says ‘I’m breathing wrongly’, my response is often to reassure him that it may well be fine for general living, as it is for many people. ‘Breath reprogramming’ for speaking (or singing) can give him a healthier and more efficient pattern to power the voice; that is why the training of so many actors and singers includes breath work.

Chapter 9

Channel work foundations

Voice is shaped by the channel The power of voice and its connections to word and psyche are far more than mere mechanics, but, no matter how remarkable the voice, at a simple level we are hearing vibrations in a tube. The adjustments in the shape of that tube – the channel – alter the vocal folds’ ‘basic buzz’ into a person’s resonance and speech. In clinical literature that tube is considered to be the vocal tract, which runs from the level of the vocal folds to the front of the lips or nose. In adults, the average length of a vocal tract is around 17 cm (Denes and Pinson 1993), with a man’s vocal tract generally longer than a woman’s. As described in Chapter 5, the word channel has a slightly wider reference than the vocal tract alone, because it includes the shape and muscles of the face. It also refers to the flow of vocal energy along the tube itself, as in ‘a free flowing channel of sound’. The following are the moveable structures of the channel: 1. 2. 3. 4. 5. 6. 7.

The The The The The The The

face lips jaw tongue soft palate pharynx larynx.

The larynx appears in this chapter because its height in the neck and the tension of its extrinsic muscles affect the shape and tension of the ‘tube of sound’. Details of its structure and intrinsic muscles are considered in Chapter 10. Of course such a division is artificial but it provides a way of looking at slightly different aspects of the functional voice system.

Speakers have habitual long-term channel settings, and the ability to deliberately alter them People vary hugely in the patterns of their channel shapes and tensions as they speak. Some are permanent, as in an observation such as ‘his habitual lip setting is quite rounded’. Others

Voice Work: Art and Science in Changing Voices. Christina Shewell © 2009 Christina Shewell. ISBN: 978-0-470-01992-4

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are temporary and result from a deliberate action, as in ‘She’s creating just the right tongue setting for that Northern Irish dialect’ or ‘If we could release that slight pharyngeal constriction, his whole tenor sound would be freer’. Any setting should allow a speaker or singer to healthily and effectively convey the meaning, artistry or emotion that he intends. In ordinary speaking most people do not consciously shape the moveable areas of the channel; alterations happen as a result of the auditory environment in which we grow and live, and the physical and emotional influences on our bodies. If speakers are aware of what they are doing, they have considerable control over the shape and tension of the channel. We deliberately manipulate the settings when we ‘do funny voices’ or try to copy another voice, and conscious control is a crucially important part of a singer’s skills. Figures 9.1 and 9.2 give a clear picture of the channel. We can see the shape of these speakers’ facial profiles, the bony structures of jaw, vertebrae and hyoid bone, and many of the soft tissues of the vocal tract. Although these xeroradiographs show different people, they provide a beautiful illustration of how the vocal tract can dramatically change shape. In Figure 9.1 the vocal folds and hyoid bone are in a neutral resting position as the person is silent, whereas in Figure 9.2 you can see how the jaw is wide open, and the hyoid and larynx have risen to just below the tongue base as the speaker screams.

Figure 9.1 Xeroradiograph of vocal tract – no voice. (Produced with permission of the Department of Human Communication Science, University College London, from the Frances MacCurtain archive.)

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Figure 9.2 Xeroradiograph of vocal tract – loud, high scream. (Produced with permission of the Department of Human Communication Science, University College London, from the Frances MacCurtain archive.)

Changes in the shape of the channel create the formants of the voice Unless they are pure tones (as we can hear from a tuning fork), all sounds contain a series of tones, and the vibrating vocal folds of the larynx are no exception. If you intone a long eee at middle C pitch, your vocal folds vibrate at around 261 times each second. A listener’s ears will hear that fundamental frequency (symbolised as F0) as the core pitch of your voice at that moment. But at the same time the vibrations of the vocal folds are also producing other ‘overtone’ or ‘harmonic’ frequencies above that basic frequency. As the tone travels through the vocal tract, some its frequencies match the natural resonance frequency of the spaces, and that extra ‘burst of resonance’ is called a formant. They ‘are then radiated with a high amplitude from the resonators’ (Brown 1999). David Howard describes these as ‘larynx tones for which the vocal tract has a preference’ (personal communication, 2008). The detailed spectrographic analysis of formants, using computer technologies, belongs to the field of speech science. Voice practitioners primarily need to understand the following: • It is different combinations of formants that make one vowel sound different to another.

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• Part of the individuality of each speaker’s voice is created by his particular patterns of vocal tract shaping, which produce particular formants, his unique resonant qualities. • By shaping the vocal tract in particular ways, we can produce particularly strong formants. Even without amplification, highly trained classical singers can be heard over a vast orchestra, because they have learnt to produce the ‘singer’s formant area’, high energy harmonics at around 3000 Hz.

The face The face is the mask through which we speak Facial appearance and expressions are hugely influential in the judgements people make of character and mood, because they are the masks that we present to the world. They are also the ‘masks’ through which we speak and, as many actors know, wearing another mask affects our own feelings. How our own faces move and feel can directly affect our own emotions. Gladwell (2005) quotes the findings of psychologists Ekman and Friesen (1978) who found that, if individuals ‘put on’ certain carefully specified facial expressions of anger, fear or sadness, their autonomic nervous system was directly affected. The assumed facial expressions created physiological changes and the feelings of those distressing emotions, while energy or pleasure expressions had a positive effect on mood. Figure 9.3 shows the extensive network of facial muscles that are involved in facial expression.

Epicranial aponeurosis

TEMPORALIS OCCIPITOFRONTALIS (OCCIPITAL BELLY) Posterior auricular Zygomatic arch Mandible MASSETER Sternocleidomastoid Splenius capitis Trapezius Levator scapulae Middle scalene

OCCIPITOFRONTALIS (FRONTAL BELLY) ORBICULARIS OCULI ZYGOMATICUS MINOR Nasalis LEVATOR LABII SUPERIORIS ZYGOMATICUS MAJOR LEVATOR ANGULI ORIS BUCCINATOR RISORIUS ORBICULARIS ORIS DEPRESSOR ANGULI ORIS DEPRESSOR LABII INFERIORIS MENTALIS PLATYSMA

Figure 9.3 Main facial muscles. (Reproduced with permission of John Wiley & Sons, Inc. from Tortora and Derrickson 2006, Figure 11.4, page 340.)

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The facial muscles also affect our voices Voice warm-ups often include facial massage, stretching and contortions to enliven the sensation, tone and movements of the mask. Facial muscles form the external ‘sounding board’ for the vibrations in the mouth and nose; resonance is improved by firm tone of the muscles, whereas flabby muscles absorb sound. Adequate muscle tension and mobility are essential for clear speech sound articulation and to a general impression of ‘lively speech’. As with many of the fine muscles involved in voice, concentrated active work on facial muscles can change their tone and efficiency of movement. The work of the Eva Fraser Facial Fitness Centre in London is based on the belief that specific intense exercise routines can preserve and restore the face, and protect it from the seemingly inevitable sagging and wrinkles. The changes reported by their clients do provide support (as yet anecdotal) that appropriate intensive facial and neck muscle exercise can also change long-term structure – something that is highly relevant for voice muscle work.

The lips Lip settings and movements affect voice quality The lips are of course part of the face but their action has a particularly powerful effect on speech and voice. If the muscles in and around the lips are active, the rest of the face can be relatively immobile and the voice still sound normal; the reverse is not true. Laver’s (1980, 1991) work clarified the way that changes in lip spreading and rounding have a strong effect on the overall vocal sound. You can hear this if you count from 1 to 10 with your lips in a ‘smiling, stretched-wide’ setting, and then contrast that by counting with rounding and slight protrusion of your lips. (In each case try to keep the rest of your channel the same – don’t tighten your throat or jaw.) In the rounded position your voice sounds ‘deeper’ as the vocal tube becomes a longer resonating space. It is an important factor to bear in mind when working with a male client who wants to sound more female – whether for transgender or theatrical demand. Lip rounding may appear more feminine but the voice may sound lower in pitch. It is more effective to work on the range of lip movement, which is generally more extensive in women.

Adequate lip movement energy is part of voice projection and protection Lively movement of the lips can contribute to the avoidance of throat constriction, by focusing the energy to the front of the vocal tract, creating a forward resonant quality: ‘active lips reduce the participation of intrapharyngeal muscles’ (Gullaer et al 2006). Slightly exaggerating the lip movements helps the sound of the words to carry across space, and listeners can gain extra information from lip-reading if they are close enough. I have encouraged this practice in the speech of a profoundly hearing-impaired young woman, whose intelligibility was very limited because her tongue shaping for vowels was so inaccurate. Practical work on lip movements was easy for her, and their increased activity gave listeners important extra clues.

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Laver (1980) pointed out that the voice has a particular auditory characteristic if the speaker has a pattern of the upper teeth touching any part of the lower lip. This ‘labiodentalised’ voice is part of many speakers’ habitual lip settings, and need neither look like a chipmunk nor sound like a lisp.

Jaw The lower jaw drops away from the skull by the action of the temporomandibular joint This joint has great delicacy and great strength – delicacy as it moves quickly and easily as we shape the many sounds of speech, and strength as the muscles move it to chew the toughest meat or the largest mouthful. The temporomandibular joint (often referred to as the TMJ) moves forwards and downwards like a hinge when the mouth opens, and also allows a restricted sideways movement. However, that side-to-side action is designed only for the slight movement used in chewing, not for large slewing gestures. Clients sometimes move their jaws vigorously from left to right, in the mistaken belief that this is a good loosening exercise. I point out that, although sheep do that when they are chewing grass, humans are not ruminant mammals with jaws that can move in that way. Some voice exercises use the image of the upper jaw moving up and away from the lower, but the upper jaw is part of the skull itself, whereas the lower jaw hangs below it. Opening the mouth with the image of ‘lifting’ the upper jaw away from the lower may give a sensation of stretch and opening to the mouth and back of the throat, so long as the back of the neck is not too compressed.

Releasing the jaw is highly relevant for the voice Unless the lips move very little, we can often see the effect of a tight close jaw joint pattern because the gap between the top and lower teeth will generally be narrow or even invisible when someone speaks. As people vary in their teeth alignment, we also need to listen for it. Even in a recording, we can hear it in the resonance of the voice, as the inside mouth space is smaller and the exit for sound is narrower. This sound is also affected by whether the lower jaw protrudes, and by how much it moves in talking. Habitual jaw tension and range of movement are very important for the sound of the voice. Speakers and singers are often unaware of a tendency to speak with a close or clenched jaw setting. Work on jaw release in the conversational speech of singers can sometimes significantly improve their whole singing vocal tone. As Chapman (2006) writes ‘inappropriate muscle tensions in jaw, tongue root and pharynx can cause the soft palate to be pulled down’. The phrasing of the instructions that we give for jaw release are important. ‘Let the jaw drop’ encourages the muscles around the TMJ to release with gravity, so that the lower jaw drops into a slightly open position, at the same time slightly widening the pharynx. ‘Open the jaw wide’ often causes an effortful stretching with excess tension

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in the muscles around both the jaw joint and elsewhere in the vocal tract. The ‘jaw-drop’ test in Chapter 20 describes a way to tune a client in to his habitual pattern of jaw setting, and to identify the difference between jaw release and jaw stretch. It is important to recognise that the extent of lip movement and tension need not be the same as that in the jaw. As listeners, our first impression may be wrong, so both the VPAS (Vocal Profile Analysis Scheme) and Voice Skills Perceptual Profile (VSPP) perceptual schemes identify both lip and jaw settings, so that exercises can be targeted appropriately.

Voice story: Nancy Nancy was a 35-year-old forensic pathologist who had long-term voice problems since her early 20s, and three recent periods of complete voice loss. The ENT report said that she had ‘subtle thickening of both vocal folds in the middle third’ – early signs of vocal nodules. Nancy said ‘I’m a big communicator and my voice problems stop me talking and singing – which I love’. Her spoken voice was creaky, with a very limited pitch range. She was physically fit, but she frequently had neck and back pain; I found that she had very tight shoulder muscles, and an extremely tight close jaw pattern. She told me that she had not been aware of this in speaking, but had long ground her teeth at night. Her dentist said that this was the reason why she had cracked two back teeth in the last year. One had been crowned and she was waiting for the other to be done, as it was so often painful. As Nancy’s jaw muscles were so unusually tight, and contributed to tension throughout her channel, work started with an intensive programme of jaw release exercises. She was rigorous at practising, and smiled as she told me that she sat for long stretches of time behind her microscope, doing the basic jaw-drop exercise. After 4 weeks, there was a clear improvement in her vocal quality and jaw tension. After 8 weeks of voice therapy and personal practice, Nancy no longer had any voice problems and told me that she had found two additional positive effects: 1. The pain in her cracked tooth went, so she and the dentist decided that there was no need to fit a crown unless the pain returned. 2. She discovered a quick way to release stress at work: ‘If I drop my jaw it has an amazing effect on everything, and I feel my shoulders go down and body loosen.’

The clicking jaw can be a tension feature but may need checking by a dentist All voice practitioner groups may encounter this in jaw release work with a client, and it can be of concern. Often the click is due to an excess pattern of TMJ tension, but an opinion from the client’s dentist can be very helpful. Dentist Duncan Grossett explains: ‘The part of the lower jaw [the mandible] which fits into the upper jaw is called the condyle, and has a fibrous capsule over its head. As you open your mouth and the jaw moves forward and

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down, both condyle and capsule should also move. However, if the masseter and temporalis muscles are very tight, sometimes the lower jaw moves down, but the capsule is left behind. As the head of the condyle moves out of its capsule, you can hear and feel a click’ (personal communication, 2006). Occasionally a clicking jaw may be an early warning of a tendency for the mandible bone to dislocate and literally to slip out of its joint. It can usually be quickly pushed back, but the lower jaw muscles are likely to go into spasm if the mandible remains out of its joint socket for more than 15 minutes. It is then more difficult to get back, and the client will need to be sedated to release the muscles and allow the jaw to be pushed back. Jaw clicking may or may not occur in malocclusion, when the lower jaw protrudes past the upper jaw. Occasionally this is part of a congenital malformation, but may develop during the growing process. Then the lower jaw may move forward or to one side as it tries to compensate to get the teeth to meet, and this can set off a reaction of stress in the facial or neck muscles.

Jaw problems can have wide effects Dentists and orthodontists offer advice to clients with any kind of jaw problem, and an osteopath can sometimes be of help as well. Sometimes it is not just the local jaw muscles that are involved. This wider effect on the body was described in a newspaper report (Brennan 2001) that told the story of actor Nigel Planer. His mixed health problems included irritable bowel syndrome, chronic sinus problems, lower back pain and a sensation as if he ‘had a chicken bone stuck at the back of my throat’. His dentist established that, although a childhood brace had straightened his teeth, they had grown in such a way that the lower teeth did not fit under the top teeth, and pushed forward. For years, Nigel Planer had been trying to push his lower jaw back, causing a significant strain on the muscles at the back of his neck, and affecting his lower back. He began to wear a custom-made dental splint to realign his bite, with the aim of changing the angle of his jaw joint so that, instead of being stretched backwards, it would gradually relax. After wearing this most of the time for a year, he was reported as feeling a 75% improvement in all symptoms, and described his life as transformed.

Tongue The tongue shapes speech sounds and resonance As a student speech and language therapist, I was taught nothing of the tongue’s importance as the mobile shaper of the oral and pharyngeal resonating spaces. Figure 9.4 shows the size and extent of the tongue as it lies in the channel; the part that we see when we open our mouths or stick out our tongue is only the top level, because the tongue curves round in a large muscular ‘C’ shape. If you do ‘the tongue base jiggle’ exercise in Chapter 20, your fingers are actually pushing up under the chin on three muscles that run under the jaw and form the floor of the mouth. Some voice teachers call this area the tongue ‘root’,

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Inferior nasal concha

Pharyngeal tonsil Opening of auditory (eustachian) tube

Hard palate

NASOPHARYNX Soft palate

Oral cavity

Palatine tonsil Fauces

Tongue

OROPHARYNX Lingual tonsil Epiglottis

Mandible

LARYNGOPHARYNX (hypopharynx) Hyoid bone Thyroid cartilage (Adam’s apple) Esophagus Cricoid cartilage Trachea

Figure 9.4 The pharynx, showing the size and depth of the tongue. (Reproduced with permission of John Wiley & Sons, Inc. from Tortora and Derrickson 2006, Figure 23.4, page 851.)

but anatomically the tongue root is at the far back and bottom of the tongue. The root forms the front wall of the pharynx, and can push forwards to expand the tube, or pull backwards with the effect of constricting.

Tongue position and tension affect the larynx The tongue is a mass of muscles covered by mucous membrane. Extrinsic muscles control the tongue’s placement in the mouth, whereas its inner muscles change its shape. The coordinated movements of all the muscles are necessary for chewing, swallowing and speaking. In Figure 9.4 the important hyoid bone is clearly seen. The tongue root is attached to the hyoid bone and the larynx hangs from the hyoid – so tongue position affects the height of the hyoid bone, and therefore the place of the larynx in the neck. If you place a finger lightly on your larynx and strongly extend your tongue, you will feel the larynx rise a little. Pull the tongue back as far as possible, and you may feel the larynx move down, as the spaces are compressed.

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The tongue has poor proprioception Proprioception is the sense that tells us where parts of our body are in space. The foot has refined proprioceptive sense, so that you will be able to feel the exact position in which it lies. The tongue has poor proprioceptive sense, so it sends limited messages to the brain about its exact position in the mouth. Consonant positions are relatively easy to identify, because there is usually actual contact or friction involved, but identifying where the tongue is positioned to make vowels is more difficult. This can cause problems when speakers are trying to change tongue positions – as in the acquisition of a dialect.

Alveolar consonants can be made with tongue tip or tongue blade We know that tongue shape and contacts within the mouth create most of the speech sounds of all languages. The consonants /t/, /d/, /s/, /z/, /l/ are made by part of the front of the tongue touching against the alveolar ridge, just behind the top teeth. Some people use the tip of their tongue as this ‘active articulator’, and some use the blade area slightly further back. As a student trained in the early 1970s, I kept quiet about my finding that I appeared to be the only student in my year who did not use the tongue tip for alveolar consonants, in case this might be an impediment to my work. Nowadays, whenever I do a quick survey of the ‘tip’ or ‘blade’ active articulators in a group, the numbers are roughly equal. For the spoken voice, and most genres of popular singing, it does not matter which is used; for certain demands of classical singing, it may be important to use the tongue tip. Practitioners should always find out whether a client uses tongue tip or blade as active articulator, to avoid giving instructions that confuse and conflict with a client’s own long-term tongue pattern. The contact of that active articulator varies between speakers in its precise placing on the alveolar ridge. Laver (1980) pointed out that the tongue tip or blade may be habitually quite advanced, possibly even touching the back of the top teeth, whereas other speakers use a pattern where the tongue is retracted towards the hard palate. You can explore the differences in the sound of your voice as you speak the phrase ‘ten tiny tortoises tugged at the tent’ several times, each time placing your own tongue active articulator at different places between your top teeth and the front of your hard palate.

The habitual place and height of the tongue can affect the overall sound of a voice The degree of tongue raising or lowering, together with alterations in the backing or fronting position, shape the different vowels of a language. Laver (1980) also pointed out that speakers differ as to their long-term tongue settings. The tongue setting of a British Liverpool speaker will have a habitual pattern of a rather back placement within the mouth space, with the back of the tongue raised towards the soft palate. In South African English accents, the tongue will tend to be placed quite far forward in the mouth, with its front raised up towards the alveolar ridge. Finding the tongue settings for an accent can be of significant help for an actor trying to acquire a new dialect for a role.

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Tongue-placing differences can be heard among speakers of the same accent, and space is left within the VSPP tongue parameter for any obvious tongue-placing features to be noted. You can explore these options by speaking the same sentence several times, changing your tongue position in terms of its degree of fronting, backing, raising or lowering within your mouth. There need be no critical value judgement in describing a speaker’s habitual tongue setting, because there is huge normal variation, but we need to be aware that this may be relevant to the sound and effectiveness of a particular voice. This is particularly relevant for the sound of the sung voice but can also need work in the spoken voice. A markedly backed and lowered tongue in an actor may contribute to a ‘held back’ voice quality, and have an added tension effect on the pharyngeal and laryngeal areas. A noticeably fronted and raised tongue body with little range of movement in a nervous female presenter may contribute to a ‘prissy’ voice quality and hissing sibilants.

The range of tongue movement will affect the sound of a voice There needs to be enough range of tongue movement to ‘fill’ the vowels and make clear all the diphthongs. It is possible to speak with a barely moving tongue, and the words will be intelligible, but, even if you use extensive lip movements, the overall voice quality is likely to elicit adjectives such as ‘dull, restricted, flat or limp’. You can hear this if you speak with as little tongue movement as possible. Voice teacher and drama school principal Gwynneth Thurburn (1939) wrote ‘certain elements in speech training should repeatedly be insisted upon; loose jaws and active tongues for instance’. An animated tongue is a crucial contributor to an impression of clarity, resonance and energy. It may be missed on a first critical listening to a ‘rather boring’ public speaker or performer, but relevant work can make a huge difference. It can be interesting to ask a client where her tongue habitually lies in the mouth when she is not speaking. Sometimes a speaker or singer suddenly becomes aware that the usual resting position for his tongue is clamped up against the hard palate, pushed forward against his alveolar ridge or tightly pulled back within the mouth. These long-term postures can be relevant for a voice and for speech sound articulation, and in North America the field of myofunctional therapy works on these with orthodontic problems.

The need for surgery for a true tongue-tie is rare Voice practitioners may come across a client who says that her ability to pronounce certain sounds is limited by a tongue-tie. Anatomically this occurs when the small piece of skin (the frenulum) under the tongue anchors the front to the floor of the mouth, so the tongue cannot easily move upwards for articulation. True tongue-tie is rare, and the need for surgery even rarer, and any client should seek the opinion of his doctor or an oral surgeon. In 2004 a newspaper reported that the South Korean government was trying to halt the widespread use of this surgical procedure in children under 5. Many parents erroneously believed that the operation made the tongue longer and suppler, thereby improving a child’s English pronunciation.

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Soft palate The soft palate forms the muscular back of the roof of the mouth Voice practitioners vary in what they call this part of the channel, and names include ‘velum’, ‘velopharyngeal sphincter’ and ‘velar port’, the last two reflecting the fact that the closure of the nasal cavity from the mouth involves an upward movement of the soft palate and a slight inward movement of the back wall of the pharynx to meet it. The term ‘soft palate’ refers to the soft tissue continuation of the arched bone of the hard palate. Its trapdoor closure against the pharynx stops food moving up into the nose when we eat and creates the pressure needed for us to suck or blow.

The soft palate’s position can be down (with space between it and the back of the mouth) or up (near or against the back wall) In Figure 9.4 the soft palate is in its ‘down’ position, as it is when we breathe quietly with lips closed and air going in and out through the nose. It is also down when we make the three nasal English sounds /m/, /n/ and /ŋ/, where out-breath and vibrations exit the channel through the nose. We generally think of it as being up when we make all other sounds, so that the out-breath and vibrations then come out through our mouths. It is, however, important to appreciate that there is no simple ‘completely up, completely down’ division. Try taking out any trace of nasal tone in a sentence like ‘my mummy makes marvellous marmalade on Mondays’, and you will see how difficult that becomes, because when we speak the soft palate rarely makes a tight seal for each of the non-nasal sounds. So long as the soft palate is high enough, and most of the vocal vibrations move out of the mouth rather than the nose, the voice will not have an excessively nasal tone. If we tightly push our soft palate up against the back wall of the throat, we are likely to speak with a ‘blocked nose’ denasal type of voice quality, and this is the way that we can imitate the sound of having a heavy cold. If the soft palate is habitually too low, the voice will have too much nasal resonance (hypernasality) because too many of the vibrations leave the channel via the nose rather than the mouth. If the palate structure or movement is damaged (as in cleft palate or some neurological conditions) the nasal-exiting air may produce a friction sound which we call ‘audible nasal escape’.

Practitioners vary in how they work with the soft palate Some voice practitioners teach a high level of soft palate awareness and deliberate control, whereas others work through the medium of listening with sound play and contrast. Although most people do not naturally have good sensation as to the position of the soft palate, classical singers often develop a heightened awareness and control. Kiesgen (2002) recounts the problems he had in trying to consciously relax his palate. He reports that imagery and exercises helped ‘where reading and technical understanding had always failed’ and had contributed to a stiffening of the walls of the pharynx. Through his own exploration, he came to realise that he should not aim at a conscious holding or closing of the nasal

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port, but should instead ‘relax the muscles in that vicinity and allow the port to close naturally and gently in response to tonal concepts’. The soft palate can be a major contributor to snoring, and there are some who take the view that singing can help. Ojay and Ernst (2000) found that singing exercises appeared to reduce snoring by toning lax muscles in the upper throat. (Ojay’s CD programme of singing exercises designed to reduce snoring is listed in the website index.)

Pharynx As we saw in Chapter 8, the pharynx is the tube that runs from the back of the nose down to the level of the larynx. In voice exercises involving a yawn or widely opened mouth, clients may sometimes comment that they feel as if their ears ‘pop’. This happens if the eustachian tube, which runs from the back of the nose into the middle ear, may suddenly open to allow a small amount of air through to equalise the pressure. Indeed if you hum and at the same time quite widely open and close your jaw, allowing the ears to pop, you will suddenly hear your voice much louder than before. I sometimes use this as a feedback device in an exercise on jaw release.

Appropriate pharyngeal tension is crucial for swallowing The main muscles of the lower pharynx are called the constrictor muscles, and their increased tension is an essential part of our ability to swallow, when they tighten and squeeze food or drink down towards the oesophagus. As this happens, the larynx is pulled up and back, as you can feel if you touch your larynx and swallow.

Excess or inappropriate pharyngeal constriction may be part of an overall pattern of ‘over-constriction’ As in all channel voice work, we need to recognise the difference between positive tension and excess constriction. If the pharyngeal muscles are habitually held too tightly in speech, the voice is likely to have a ‘cramped’ or ‘choked’ quality, as the back of the tongue and the pharynx tighten (as in the voice of comedian Rowan Atkinson as ‘Mr Bean’). This may simply be an aesthetic issue because it is possible to speak with quite a marked degree of pharyngeal over-tightening and not put strain on the delicate vocal folds; this can be an actual technique in rock singing. However, excess pharyngeal and laryngeal constriction often go together and both need to be addressed in voice work.

Clients may complain of throat discomfort or the sensation of a ‘lump’ A client may refer to discomfort anywhere along the pharynx as a ‘sore throat’, and doctors often need to carefully investigate exactly where the discomfort is actually focused. Different areas of the pharynx suggest different problems (see Harris et al 1998). Mathieson (1993)

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found that the specific use of particular words may provide clues to the cause of the throat discomfort. Words such as ‘tickle’, ‘burn’, ‘sore’ and ‘dry’ generally implicated an inflammation of the lining of the vocal tract, including the vocal folds themselves, whereas the terms ‘ache’ and ‘tightness’ pointed to a musculoskeletal issue. Some clients with a voice disorder experience a feeling of a lump in the throat, often referred to as ‘globus’. This should be medically investigated, as causes include reflux, an enlarged thyroid gland or cervical osetophytes. These last are bony projections that can grow from the front surface of one or more of any of the vertebrae and can press in on the pharynx. Di Vito (1998) estimates that they occur in 20–30% of the elderly population. They are most commonly seen between the levels of the third and seventh cervical vertebrae, exactly the level at which the larynx typically lies, and so can cause swallowing problems, cough, constricted breathing, hoarseness and weak voice. However, the ‘lump feeling’ may also be part of a general pattern of too strong contraction of the constrictor and cricopharyngeus muscles. Most of us will have temporarily experienced what may even be a painful sensation while trying not to cry, but it can become a chronic part of a muscle tension voice disorder. Good voice therapy techniques can help to release the contraction, but hands-on manual therapy may be needed, with an osteopath, physiotherapist or specially trained speech and language therapist. Clients are sometimes worried that, although the doctor has told them that there is nothing to be seen in throat or larynx, they still feel the lump. The analogy of ‘bunched’ shoulder muscles can offer a reassuring image.

Work on ‘opening the throat’ will always involve some pharyngeal work The yawn posture is used by many voice practitioners to ‘open the throat’. Boone and McFarlane (1993) used nasendoscopy to look at the effects of this exercise and found that ‘performing the yawn–sigh demonstrated retracted elevation of the tongue, a lower positioning of the larynx, and a widened pharynx’. This can be seen in Figure 9.5. However, care needs to be taken in the use of the yawn. I ask clients to keep the tip of the tongue behind the lower teeth with the tongue flat to prevent the backward tongue bunching that usually occurs as part of the normal ‘real’ yawn pattern. Gullaer et al (2006) have images of the active vocal tract during the articulation of different vowels, and make an important distinction between ‘front’ and ‘back’ throat opening. Although we often encourage people to open their mouths as part of a yawn-type exercise for pharyngeal widening, we cannot assume that the throat also opens, because we may bunch the tongue upwards and backwards which may tighten and block the back of the throat. If we focus on the idea of ‘back opening’, we flatten the tongue and more space is created.

The larynx The position of the larynx in the neck (laryngeal height) varies as part of ordinary life The larynx sits at around the level of C5, but there is considerable variation among speakers in its habitual height. It is higher in babies and young children, gradually dropping during

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(a)

(b)

Figure 9.5 Two xeroradiographs showing the effect of a yawn on the pharynx: at rest (left); yawn (right). (Reproduced with permission of the Department of Human Communication Science, University College London, from the Frances MacCurtain archive.)

childhood to its lower adult position. In normal swallowing, the larynx moves up towards the lower jaw, and in yawning it drops to around the level of C7. It also rises as we move up in pitch, and although some classical singing training has encouraged male singers to limit this, great care must be taken if excess tension is not to result. The larynx may rise as muscles tighten with emotional stress; if a speaker finds that her voice suddenly becomes high when she is nervous, an upward leaping larynx may be a contributor. The larynx tends to move down on a deep inspiration. Iwarsson and Sundberg (1998) found that more breath in the lungs was associated with a lower larynx position, and vice versa. They write that ‘if lowering the larynx is a goal for a patient or a voice student, initiating phonation after a deep inhalation may be a worthwhile possibility to consider’. A prolonged ‘b’ sound (i.e. without letting the lips open) results in a markedly low larynx (Elliot et al 1997). We can deliberately vary the larynx height, and hear how it affects the voice. To feel it move high, place a fingertip on the front of your larynx (on your ‘Adam’s apple’) and start to make a swallowing movement. You will feel your larynx rise, and can then hold it there by using excess muscle tension, as you count 1 to 10 or speak a sentence. For low position,

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again place your finger on the front of the larynx, yawn and hold the larynx low as you count or speak. There will be a significant difference in the sound. The larynx position may be relevant to a speaker’s particular vocal problem. In over-tense voicing, the larynx and hyoid bone are often held in a habitually high position, and may need releasing. This is common in cases of puberphonia (see Chapter 27) where a boy’s voice does not drop at puberty. Sometimes a speaker arrives with an unusually low larynx position. I worked with a popular music radio announcer who had forced his larynx downwards to create a deep, macho tone; the long-term effort had created considerable excess tension, throat pain and roughness of phonation.

The tension of the extrinsic laryngeal muscles affects the height of the larynx As a university lecturer, I taught the names of all the laryngeal muscles and their functions, recognising that these would soon be forgotten after the examination was over. I did, however, encourage an appreciation of their number (around 15 extrinsic and 12 intrinsic muscles) because this can help students and clients understand the delicate complexity of phonation. The extrinsic laryngeal muscles affect the larynx position in the neck and alter the shape and length of the vocal tract. They fall into two groups, each with four muscles: 1. The suprahyoids (above the hyoid bone) all raise the larynx, pulling it forwards. 2. The infrahyoids (below the hyoid bone) move the larynx downwards and pull the thyroid cartilage and the hyoid bone closer together. Although they are not technically part of this group, muscles such as the sternocleidomastoids and scalenes in the neck, and the big trapezius, spanning the shoulders and upper back, also affect laryngeal height and tension by altering the head position. The intrinsic laryngeal muscles move the vocal folds and cartilages in relation to each other, opening and closing the folds, controlling pitch and altering phonation quality. Chapter 10 describes these muscles in the context of phonation.

Chapter 10

Phonation work foundations

The term ‘phonation’ refers to the action of the vocal folds as they open and close in vibration to produce sound waves Some voice practitioners may have seen a slightly gruesome but fascinating film of air being blown through a dissected larynx; the vocal folds can clearly be seen to vibrate and a slight buzz emerges. That ‘buzz’ is shaped and amplified into recognisable ‘live’ voice by the channel above. Nevertheless the structure and function of the vocal folds are crucial to the sound of a voice; the best silver saxophone is no use without a good quality reed. Phonation is an enormously complex activity, and our understanding of the way that it works continues to deepen, with a wide range of sources describing its intricacy of form and function. Writers vary in their views of how much we can sense and deliberately change the aspects of phonation. Thurman and Welch (2000) take the view that we have limited control over the voluntary movements of these aspects: ‘the human larynx does not have sensory nerve networks that report spatial location and movement into conscious awareness.’ Some voice practitioners believe that thorough teaching can enable us to gain considerable conscious control in moving certain parts of the larynx.

The external larynx is an intricate structure of bone and cartilage Figures 10.1 and 10.2 give some idea of the way that the larynx is constructed. Figure 10.1 shows the structures ‘as if’ separated from each other; they fit together like an intricate three-dimensional jigsaw. Figure 10.2 shows a front view of the larynx. Too much laryngeal muscle tension can narrow the spaces between hyoid bone and thyroid cartilage, and between thyroid and cricoid cartilages, pulling the structures together and affecting the voice. Even when we are familiar with drawings such as these, it can be difficult to visualise the three-dimensional reality, and to then imagine many of the parts moving at different times in different ways in those three dimensions. Although superior to drawings, even a commercially produced medical model of a larynx cannot show the complex movements of the

Voice Work: Art and Science in Changing Voices. Christina Shewell © 2009 Christina Shewell. ISBN: 978-0-470-01992-4

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Hyoid bone

Epiglottis

Thyroid cartilage

Arytenoid cartilage

Cricoid cartilage Rear view Trachea

Figure 10.1 The larynx: bone and cartilages. (From Shearer 1979. Courtesy of Charles C. Thomas Publisher Ltd, Springfield, IL.)

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Epiglottic cartilage Hyoid bone Thyrohyoid membrane

Vocal fold

Cricothyroid membrane

Superior cornu

Body

Thyroid cartilage

Inferior cornu Cricoid cartilage Tracheal rings

Figure 10.2 Front view of laryngeal cartilages. (From Dhillon and East 1994, page 55. Reproduced with permission of Elsevier. © Churchill Livingstone.)

folds. Computer technology is, however, increasingly able to create virtual images to clarify laryngeal activity.

The height of the hyoid bone in the neck can be relevant for voice Abitbol (2006) suggests that, because this small bone ‘holds fast the powerful muscles of the tongue’, its occurrence in Neanderthal skeletons points to the use of some form of spoken language. The hyoid bone is the only human bone that is not attached to another bone. Instead it ‘hangs’ in the neck; the muscles above it join onto the tongue, and muscles below attach to the larynx, so it inevitably moves in the production of human speech. Lieberman (1998) explains how manual therapy on these muscles can be relevant in voice therapy.

The epiglottis protects the larynx and lungs, and has a role in vocal resonance Shaped like a vertically standing tongue, the epiglottis is attached to the inner surface of the thyroid cartilage, and is usually considered part of the larynx. As described in Chapter 8, it has an important role in protecting the lungs, because it closes the entrance to the trachea while we are swallowing. It also plays a role in shaping an aspect of vocal resonance.

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Epiglottis

Vestibule Ventricular folds

Vocal folds

Thyroid cartilage

Trachea

Figure 10.3 Diagram of the epilarynx tube, or laryngeal vestibule. (Reproduced with permission of Professor Ingo Titze from Titze 2001.)

The epiglottis forms the front wall of the space above the vocal folds, with the aryepiglottic folds running back from the epiglottis to the arytenoid cartilages. Titze (2001) calls this short tube the ‘epilarynx’, but it is also referred to as the laryngeal vestibule or aryepiglottic sphincter (Figure 10.3). When this area is narrowed from front to back, it can play an important role in producing a strong ‘ringing’ quality linked to the carrying power of the singing or spoken voice. This area can tighten quite independently of any vocal fold tension.

The space between thyroid and cricoid at the front of the larynx is important for voice The thyroid cartilage ‘sits’ on top of the cricoid cartilage. When it is not tilted forwards, you may be able to feel a small hollow at the front of your neck, between the two cartilages (labelled as the cricothyroid membrane in Figure 10.2). If you place your finger on that hollow and hum, you may actually feel vibrations under your finger. Harris et al (1998) call this area the cricothyroid ‘visor’ because it behaves like that part of an old-fashioned metal helmet that could be lifted or lowered to protect the face.

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Sometimes the cricothyroid visor closes up, as when the thyroid cartilage tips forward on the cricoid, lengthening the folds so that we can produce higher-pitched sounds. At other times, if we want to produce a comfortable lower-pitched voice, the space opens wider. So long as the visor can regularly return to neutral, there is a healthy flexibility of the thyroid– cricoid tilting function. Sometimes, however, the membrane becomes habitually too tight, and can contribute to phonation problems.

Within the thyroid ‘cartilage box’ lie the false and true vocal folds Figure 10.4 is an old image of a cross-section of the larynx which gives a very clear idea of the shape of the false and true vocal folds, showing that they are indeed folds of tissue, rather than thin bands suggested by the older term ‘vocal cords’.

Figure 10.4 The cut-through larynx from the back.

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The false (or ventricular) vocal folds help us build up pressure, but should not vibrate when we speak The false vocal folds are formed from the upper portion of the thyroarytenoid muscle, the lower part of which forms the true folds. Abitbol (2006) describes how they are well developed in mammals that habitually swing from trees, because their tight closure allows for a strong inside-body pressure. Tree-swinging is not a frequent human activity, but we do need to be able to tightly close our laryngeal area for lifting, pushing or forcing activities such as coughing, defecation and the labour of giving birth. Both false and true vocal folds are part of that valving, and both protect the lungs during swallowing. Although they should not vibrate during voicing, the false folds may move slightly inwards during speaking, as indeed do my own in ordinary conversational voice. The Estill Voice Training SystemTM identifies three possible positions: constricted, mid and retracted; this system (and other) practitioners believe that speakers can be taught to recognise their production of these positions. In the deconstriction actions of an open throated laugh or pretend sob, the false folds move widely apart against the sides of the epilarynx. As deliberate techniques these need to be well taught by a trained practitioner, because there are patterns of both emotional laughing and crying in which both pharynx and larynx are constricted. During front–back narrowing of the epilarynx, the false vocal folds should not move inwards but stay back against the wall of the laryngopharynx. Titze (2001) writes ‘how this is done is still something of a mystery’, but it is important for those qualities he refers to as ring and twang. These are further described in Chapter 11. Some speakers have too much false vocal fold closure as part of a general pattern of laryngeal constriction, and this over-tightening will need to be addressed. For any client who has voice strain or vulnerability, any exercise involving strenuous pressure should be discouraged until things improve. An unusual voice disorder occurs when a speaker uses only his false folds to phonate.

Voice story: Joe The mother of 12-year-old Joe told me that he had always had a hoarse voice, but they had grown used to this until it seemed to become deeper and more hoarse as he approached puberty. The ENT examination found that, although his true folds worked normally for coughing and throat clearing, Joe used only his false folds for voice. In the first session he was able to produce true fold phonation by using Boone’s technique of inspired voice (speaking on the in-breath), and we used this in a step-by-step approach until he was able to use his true folds all the time.

Mucus for moisturising is produced by the vocal tract membranes In the trachea and laryngeal ventricle (the space between the false folds and the true folds) lie many tiny mucous glands. These continually secrete mucus for lubrication and to help trap dust or irritants. In the nasal cavity and upper pharynx, mucus is moved down towards

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the oesophagus so that particles can be swallowed. Mucus from just above the larynx is moved upwards, so that it can tip over to the other side of the epiglottis to be swallowed. Although talking about mucus is not immediately appealing to clients, it may be important that they appreciate its vital role in keeping the vocal folds ‘moisturised’. That term is useful for its familiarity, and we can point out that many women (and some men) use a moisturising cream on faces or hands to keep the skin supple. If the vocal fold surfaces are not kept moist enough, their viscosity (stickiness) may be too high, or too dry and they will not have the pliability and flexibility that they need (see Chapter 16).

The structure of the vocal folds is part cartilage and part flexible membrane over muscle The front three-fifths of the fold is an elastic flexible membrane, and it is this part that vibrates most strongly. The back two-fifths vibrate much less as they are the pointingforward part of the arytenoids, and therefore made of cartilage covered in mucous membrane. You can make this vibrate if you do a deep creaky voice, but it is not a healthy long-term pattern. Although simple diagrams such as Figure 10.5 are useful to draw when explaining vocal folds to a client, they are limited by their two-dimensional view and cannot show that the three levels of aryepiglottic folds, false folds and vocal folds at the deepest level. As seen in Figure 10.3, the vocal folds themselves have depth, so they can be thick or thin. To give some idea of this, I sometimes demonstrate the fold of skin between my thumb and my forefinger as a parallel. It is not a perfect analogy, but it gives some idea of vocal fold shape, and its stretch, when the thumb is moved away from the finger and back in again, conveys the idea of the ability of the folds to thicken and thin, and to lengthen and shorten.

FRONT Epiglottis

Vocal fold

Ventricular (false) fold

Aryepiglottic fold BACK Figure 10.5 Simple hand-drawn diagram of vocal folds drawn from above: folds wide open.

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The internal cell structure of the vocal folds is multi-layered Figure 10.6 shows the internal microscopic structure of the vocal fold layers, and a summary of how they move, inspired by Harris et al (1998). Normal phonation depends on the health and complex movement of these layers. A highly specialised knowledge of detailed vocal fold histology is vital for phonosurgeons. It is also relevant for an in-depth understanding of vocal fold health, because minor changes happen regularly to the strong and delicate structure of all our vocal folds. To give just four examples: 1. Repeated vibration may affect the blood circulation of the lamina propria layers, so impairing the removal of excess heat or lactic acid. This may be a contributor to the symptoms of vocal fatigue (McCabe and Titze 2002). 2. ‘Even the act of daily phonation causes mild superficial layer vocal fold tissue injury, a repetitive strain injury.’ Such changes can become pathological if there is significant enough long-term damage (Casper 2007). 3. Changes to the vocal fold appearance can be detected after a singer has been singing vigorously for an hour. 4. An increase in the amount of fluid in Reinke’s space can occur if we shout, sing or use the voice in unusual ways. This may make us slightly hoarse but usually resolves within hours. The fact that all these changes are usually temporary demonstrates the normally good bodily repair system that happens during vocal fold rest, usually each night.

The intrinsic laryngeal muscles and their actions The two arytenoid cartilages swivel inwards and outwards at small joints on the cricoid cartilage to open and close the vocal folds. The arytenoids slide and rotate in a complex manner. The vocal folds and cartilages move in relation to each other, opening and closing the folds, controlling pitch and altering phonation quality. Table 10.1 summarises the actions of the inner laryngeal muscles. Table 10.1 Intrinsic laryngeal muscles and their actions.

Action within larynx

Muscle that makes this happen

CLOSE, shorten, tense and thicken the vocal folds CLOSE the folds

Thyroarytenoid (paired) (lower part is vocalis muscle, within the fold) Lateral cricoarytenoid (paired)

Both bring arytenoid cartilages together, so help CLOSE the folds Pull the epiglottis down over entrance to larynx, and can tighten the epilarynx in voicing OPEN the folds

Transverse arytenoid Oblique arytenoids (paired) Aryepiglotticus (these three are referred to as the interarytenoids) Posterior cricoarytenoid (paired)

Weak vocal fold closure, but main action is to LENGTHEN the vocal folds, as the cricoid cartilage is pulled closer to the thyroid

Cricothyroid (paired)

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Epithelium Superficial layer (Reinke’s space) Intermediate layer (elastic fibres)

Lamina propria

Deep layer (collagen fibres) Vocalis muscle

THE FIVE HISTOLOGICAL LAYERS

Epithelium (the outer layer); covered by mucous membrane.

Superficial layer of lamina propria: gelatinous (Reinke’s space). Strong vibrations in phonation.

THE TWO FUNCTIONAL LAYERS

The Cover This travels over the vocal fold body in ‘mucosal waves’. These begin on the under surface of the fold, and travel up and over the top of the body of the fold, so its movement is in a vertical dimension.

Intermediate layer of lamina propria: elastic fibres. Deep layer of lamina propria: collagenous fibres. Vocalis muscle: the middle part of the thyroarytenoid muscle. It controls the shape and tone of the vocal fold.

The Body This ‘bounces’ inwards and outwards in a slightly elliptical path.

Figure 10.6 Vocal fold layers and how they move. (Reprinted from Mathieson 2001, Figure 2.11, page 29 with permission. © Whurr Publishers.)

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One nerve supplies all the intrinsic laryngeal muscles except one Two branches of the vagus cranial nerve run to the laryngeal muscles, the recurrent laryngeal nerve (RLN) and the superior laryngeal nerve (SLN). The first supplies all the muscles except the cricothyroid. If the RLN is damaged by surgery, accident or even a bout of flu, one vocal fold may not open or close normally. So, if you are ever faced with a client or student whose voice quite suddenly becomes very weak, breathy and strained, vocal fold palsy is one possible cause. The cricothyroid is the muscle that lengthens the vocal folds so controlling pitch, and very occasionally damage to the SLN may cause a problem in pitch control.

Vocal fold movements The vocal folds have many cycles of opening and closing each second Figure 10.7 shows the sequence involved in just one vibratory cycle of the vocal folds; there will be thousands of vibratory cycles in each minute of voicing.

(1)

(2)

(3)

(4)

(6)

(7)

(8)

(9)

(5)

Figure 10.7 Normal vocal fold vibratory cycle – closing and opening. (Reprinted from Mathieson 2001, Figure 4.1, page 71, with permission. © Whurr Publishers.)

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In quiet breathing, the vocal folds are held open by the posterior cricoarytenoid muscles. When we decide that we want to speak or sing, the brain readies the vocal folds, sending a message to the lateral cricoarytenoid muscles to move the folds into the midline to close. A column of air moves out from the lungs, and that air pressure blows opens the bottom of vocal folds and continues upwards to open the top of the folds in a ‘puff’ of air. Air pressure drops, the folds close again, the pressure again builds up and they are again pushed open. This is the Bernoulli effect, with its important concept that it is air that powers the voice, not our conscious repeated act of opening and closing the vocal folds by deliberate muscle action. That would be impossible, because, as we have seen, these vibrations happen many times a second. If a woman’s average pitch is centred around A3 on the piano (220 Hz), and she talks for 5 hours a day, her vocal folds will open and close at least 4140 000 times. One exhausted singer wept when I told her those figures: ‘Oh my poor tired cords – they have to work so hard.’ Of course the vocal cords were a metaphor for her of how fraught and overstretched she felt, and both she and her cords desperately needed rest and support.

The vocal folds vary in how long they stay open or closed In each vibratory cycle, the period of time that the vocal folds are touching together is called the closed phase, and when apart it is referred to as the open phase. The length of time affects the phonation quality, e.g. breathy voice will tend to have a longer open phase whereas a pressed, loud voice will have a longer closed phase. The vocal folds open and close during other activities. We have seen that they may close in effortful movement, and are also active in wind instrument playing, where they help regulate the airflow. This may be relevant if a speaker is trying to ‘rest his voice’ and wants to continue playing his wind instrument. Weikert and Schlomicher-Thier (1999) found that the vocal folds of saxophonists open as the player takes a breath and are partially closed all the time that notes are played.

The mucosal wave movements may be wide or narrow If we use videostroboscopy to look at normal vocal folds as they vibrate, we should see a kind of ‘ripple wave’ (Thurman and Welch 2000) as the flexible vocal fold cover travels over its body. In loud voice the waves are wide, moving in big movements from centre to sides, whereas the quiet voice will have much smaller waves (a smaller amplitude of vibration).

The vocal folds may be thick or thin as they vibrate As they vibrate, the vocal folds can vary in the thickness or thinness of their ‘mass’ to create different qualities of voice. In the ‘thin-fold’ phonation pattern, the vocalis muscle within the fold slightly tenses to shorten the fold, without making it thick or firm. There is a short closed phase with small mucosal waves and the voice sounds rather thin and breathy – what

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Harris et al (1998) call ‘little girl’ voice. In the ‘thick-fold’ pattern the folds close with ‘bulkier’ edges; there is a longer closed phase and wider mucosal waves, so the voice sounds louder. We can speak at the same pitch with thin or thick folds but our voices will sound different. The overall vocal fold mass can become permanently thinner in an elderly speaker and in some muscle-wasting neurological conditions or long use of inhaled steroids for asthma. Folds also become thicker if there is a generalised swelling, as in acute laryngitis or other voice disorders (see Chapter 27).

The whole length of the vocal folds may not be closed in normal voice We often tell clients that the length of the folds closes during voice, but many people with normal voices have a small gap at the back of their vocal folds where there is not complete closure. This is more common in women; Södersten (1994) found that 82% of the young women whom she examined, and 61% of the older women, had this posterior glottic chink.

The folds can shorten and lengthen When the thyroarytenoid muscles contract they produce a shorter, bulkier vocal fold that produces a lower pitch. When the cricothyroid muscles tighten, they tilt the thyroid cartilage forward and so stretch and lengthen the vocal folds, which are attached to the front of the thyroid cartilage. As our voices move up and down in ordinary conversation, it is clear that these two are continually adjusting as we talk; pitch is further discussed in Chapter 12.

The positioning of the vocal folds can change inside the larynx during phonation Due to the complex movements of the arytenoids, more than one position of the vocal folds within the larynx is possible during phonation. The back part of the folds may be raised and slightly open; this posture is sometimes referred to as ‘raised plane position’ (Kayes 2004). Yodellers use this sudden change for a musical or emotional effect, but an unplanned ‘yodelling’ sound sometimes occurs if speakers use an inappropriate speaking pitch or when adolescent voices are going through voice change.

The vocal folds can vary in the manner in which they close at the start of phonation, i.e. in ‘voice onset’ ‘Voice onset’ refers to the way that a phonation begins at the moment the folds close together for those first vibrations. Most writers agree that there are three main onset types, but there are a number of different terms for these patterns.

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Hard onset (pressed or glottal onset, hard or glottal attack) There is strong action by the laryngeal muscles as the glottis tightly closes just before the vocal folds start vibrating. Strong air pressure builds up under the folds, which are suddenly blown apart as sound begins. If you produce a constricted pressurised grunt, as if releasing a sound after straining to lift something, you will get the feeling of a very hard onset. Hard onset = the vocal folds close tightly before phonation starts.

Breathy onset (soft attack, whispery or aspirate onset) Here the folds begin to vibrate a fraction of a second after the audible breathy sound begins. You can produce this if you let expired air come out through the folds a little like a soft whisper, and then bring in phonation. The deliberate practice of this pattern can be a useful exercise for those who habitually use too much glottal onset. Breathy onset = audible breath escape before phonation begins.

Balanced onset (simultaneous, smooth, firm, modal or neutral onset) In this pattern there is neither hard attack nor breathy escape. The vocal folds start to vibrate as the first ‘puff’ of breath blows them apart. Sundberg (1987) says the vocal folds are drawn in towards each other 50–500 ms before phonation starts. We aim for balanced onset in an exercise that asks a student to produce a long mmm sound with no excess tension or breathiness on the phonation, and then to open this up into a long aah. Balanced onset = the vocal folds close at the almost the same moment as the airflow sets the vibration in motion.

The vocal folds also have long-term patterns of ‘phonation quality’ Laver (1980) used the term ‘phonation quality’ to refer to the perceptual aspects of voice that are produced by the manner of vocal fold vibration. He differentiated harsh, whispery and creak, all of which could occur in modal or falsetto voice. The Voice Skills Perceptual Profile (VSPP) requires listeners to identify three main qualities: rough, breathy and creak. Each of these can have excess laryngeal tension, balanced laryngeal tension or lax laryngeal tension.

Rough phonation quality: irregular vocal fold vibrations (Laver’s harsh quality) The vibrations of the opening and closing folds may be regular and rhythmic (producing what would generally be considered as ‘smooth’ phonation), or irregular, vibrating with what we might call ‘jerky’ movements, producing a rough phonation quality. Marked

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roughness is usually associated with increased laryngeal tension in the normal larynx, but will occur with any mass disturbance of vocal fold structure, with or without accompanying excess laryngeal tension. Roughness can occur only when there is some degree of phonation, so logically a rough whisper is not possible – what we will hear is a tight or strained whisper.

Breathy phonation quality: audible air escape between the folds (Laver’s whispery quality) If there is a wide gap between the folds, or their free edges make only a very brief contact during vibration, the phonation quality is likely to sound breathy. There are different degrees of this among speakers and cultural differences; generally British women have more breathy quality in their voices than most American women. Breathy phonation quality may or may not be accompanied by laryngeal constriction, so speakers can have a tight breathy voice or a relaxed sounding breathy voice. In complete whisper, there is no actual phonation as the folds do not close at any point.

Voice story: ‘The Blindfold’ The whisper can have great emotional power. In her 1992 story ‘The Blindfold’, Siri Hustvedt’s sinister male character asks a young woman to use a whisper as she describes all the possessions of a murdered girl to him. ‘The whisper is essential, because the full human voice is too idiosyncratic, too marked with its own history. I’m looking for anonymity so the purity of the object won’t be blocked from coming though, from displaying itself in its nakedness. A whisper has no character.’

In fact, of course, even the whisper is shaped by the channel above the vocal folds, so there can be a sense of character with no phonation.

Creaky phonation quality (also called vocal fry) In this, thick but rather loose vocal folds create irregular vibrations at a low frequency, with a long closed phase in each cycle. Some writers refer to this sound as ‘pulse register’. Creaky quality may be produced with a very constricted laryngeal area, but it may also be comfortably relaxed. Zeroual et al (2008) say that some front–back compression of the epilaryngeal area allows a reduction in the length and tension of the vocal folds and increases their mass. (The University of Stuttgart website has clear explanations of these, and other phonation qualities, and includes audio recordings; website listed in references.) I sometimes use the term ‘balanced vocal fold vibration’ to describe phonation that has no excess roughness, creak, breathiness or tension. We can also refer to it as ‘smooth’ or ‘easy’ phonation.

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Singing ‘registers’ created by vocal fold function The word ‘register’ has long been one of the most confusing in the literature of voice, often used interchangeably with ‘resonance’, and applied to a number of different sung vocal features. As Fourcin (2005) makes clear, terms such as ‘chest’ and head’ register developed from the singer’s proprioception of where he felt vibrations in his body. Nowadays there is general agreement that, as a singer moves through pitch range and qualities, the changes in the sound are to do with vocal fold function, not with the placing of vibrations into body spaces. For a number of different terms in register description, Henrich (2005) provides an excellent survey. I use two register terms, modal and falsetto, as identified by Laver (1980, 1991). Welch and Sundberg (2002) also use these terms with the additional ‘vocal fry’, for which I use the term ‘creaky phonation quality’. Modal register The folds vibrate symmetrically, with whole length contact. When the folds have quite thick edges in their contact, and a longish closed phase, the phonation quality will sound ‘full bodied’ and has been called ‘chest register’. If the folds are longer and the contact edges are thinner, the sound will be ‘lighter’ and has been referred to as ‘head register’. Falsetto register (also called loft) The vocal folds are thin, tense and long, with minimal vibrations; unless the voice has been specially trained (as in the counter-tenor voice) the folds do not completely close. The larynx is likely to be held quite high.

The ‘register break’ is a complex mixed phenomenon Classical and musical theatre singers are trained to be able to move smoothly between pitches so that there is no sudden crack or register break. Moses (1954) describes it as follows: ‘In singing from the highest tone possible to the lowest, the untrained singer first passes a sequence of tones which seem unified. Then he comes to a node, a switching point from which he continues with a sequence of tones of a different character. Then again he reaches another node and switches to the lower third of the range, produced in a specific tone character. The trained singer does not reveal these nodes since he has learned to unify the registers.’ Harris et al (1998) describe register change as ‘the interaction of such factors as subglottal air pressure, the physical properties of the vocal fold cover, the medial compression of the folds, the longitudinal tension of the vocal ligaments and, depending on their stiffness, the virtual vibrating mass of the vocal folds’. It is not surprising that there remains some confusion!

Chapter 11

Resonance work foundations

All voices are resonant The quality of a voice’s resonance is important to both voice practitioners and ordinary listeners. A comment such as ‘she has a very resonant voice’ uses the word as an adjective, usually meaning that the voice has power without force. If a speaker is said to have a ‘lovely warm resonance’, the listener is probably expressing a sense that the voice has a pleasant quality of breadth and depth. Resonance happens when sounds are reinforced or prolonged by resounding off a surface, or by making that surface vibrate in parallel ‘sympathetic vibrations’. So, in literal terms, every voice is resonant.

Registers are formed by the vocal folds, resonance and the vocal tract Voice practitioners have long used both ‘resonance’ and ‘register’ to refer to different aspects of sound, and this can be very confusing. We hear about chest register (a frequently used singing term) and chest resonance (often used to describe spoken voice). As we saw in Chapter 10, vocal registers are created by settings of the larynx and vocal folds. Vocal resonance refers to the way that containers above the vocal folds affect the sound of phonation so that it sounds bigger or different. ‘The vocal tract acts like a megaphone or a pair of cupped hands, in magnifying the sound that is produced at the glottis’ (Titze 1994).

Bigger resonant spaces give bigger sounds The phenomenon of different ‘magnified sound’ is often illustrated by the example of woodwind instruments. The sounds of a flute, clarinet, saxophone and bassoon differ because of their size, shape and the material from which the instruments are made. The bassoon has a deeper sound than the piccolo because it has a bigger resonating chamber. A silver flute sounds different to a wooden one.

Voice Work: Art and Science in Changing Voices. Christina Shewell © 2009 Christina Shewell. ISBN: 978-0-470-01992-4

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In general, the bigger the spaces, the bigger the sound. It also of course matters how we fill those spaces with breath and energy; we can make high volume sounds on a flute, and the most delicate soft sounds on a bassoon. Small children may come across as much noisier than large adults, but this has to do with the way children’s bodies, breath and voices work together without inhibition; adults invariably have a bigger wider potential for voice than they ever realise. The human vocal mechanism is far more complex than a woodwind instrument. Our individual vocal resonances are shaped by the anatomical structures of the channel, and by the continual internal adjustments that we make in it. Imagine a saxophone made out of flexible rubber that could change width, length and tension in different areas as it was blown, and you may picture how human resonators work.

Writers vary in what they consider to be resonating spaces for voice If we shout into a cave, we hear echoes as the sound vibrations travel around the space and echo off the hard walls. In voice it is not quite so simple. The vibrations from the larynx travel up through the throat, mouth and nose, and these can certainly be said to be resonating spaces. However, writers vary on whether the sinus (‘head’) and thorax (‘chest’) spaces can significantly resonate with sound vibrations. Howell (1994) described ‘the myth of resonance chambers in the top of the head, above the eyes, below the eyes, and in the chest, which only feel sympathetic vibrations but do not affect the sound’. Sell (2005) says that head and chest resonances are just images or ‘sensations of sympathetic vibration’. As people feel different sensations, she believes that encouraging singers to aim for these resonances is unsound and can be vocally damaging. Titze (2001) says, however, ‘the sinuses do resonate but . . . the airborne sound is changed minimally by these resonations’. Abitbol (2006) is categorical in his belief that the chest cage and the lungs can be considered to be an amplifier ‘in Man we can consider that whatever the opinion of certain scientists, the pulmonary resonance chamber does exist’.

Feeling resonance in one part of the body does not mean that sound is actually emerging out of that place We might say that a performer has strong chest resonance, because we hear a particular quality in his whole voice. If we placed a hand on his chest we might feel vibrations under his shirt, but a microphone would be most unlikely to identify actual sound pulsating from his pectorals. David Howard makes the entertaining suggestion that it might be worth measuring what difference there is in overall output sound from a clothed or naked chest. ‘I would anticipate that there is no difference, indicating that no appreciable acoustic energy is radiated from the chest’ (personal communication, 2007). If you intone a long aah as fully and loudly possible, you may feel as if you have a good strong head resonance, and that your voice is echoing in your nasal and frontal sinus spaces. But what is actually happening is that the bony structures of your hard palate, teeth and cheekbones are picking up the vibrations, and you feel them in the front of your skull. As

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your soft palate is probably up against the back wall of your pharynx, there is no column of sounded air vibrating in your nose, as your nose and upper head are closed off from the voice vibrations.

There may be many places in the body where we can feel vibrations as we voice Sundberg (1987) describes I. Kirikae’s findings of 40 different places on the body where people could feel vibrations as they voiced. This would not have surprised Grotowski (1975), who wrote that there are ‘an infinite number of resonators, depending on the control the actor has over his own physical instrument’. He described five core areas of resonance: 1. The upper or head: ‘when using this resonator one must have the sensation that the mouth is situated at the top of the head’ 2. The chest resonator 3. The nasal resonator 4. The laryngeal resonator: ‘like the roaring of wild animals, heard in some jazz, and oriental and African theatre’ 5. The occipital resonator, found in the high mewing sound of classical Chinese theatre. However, he also believed that there were other resonators, including the back of the jaws, abdomen and lower parts of the spine, and would massage a pupil’s belly to ‘loosen up and stimulate the resonator situated there’. His view was that ‘the most fruitful possibility lies in the use of the entire body as a resonator’.

Three options for resonance points 1. There are parts of the body within which the sound waves are shaped and changed, such as the pharynx, mouth and nasal cavities. 2. There are parts where we may feel sympathetic vibrations, but these do not actually contain or produce sound vibrations, so we may feel (either internally or by touch) vibrations at the back of the neck or top of the forehead. 3. There are other parts, such as the sinuses and spaces below the larynx in the bronchus and lungs, where we can feel vibrations but there is disagreement as to whether vibrating air is actually resounding within those spaces (see Chest resonance quality, page 181).

There are sensory and mechanical approaches to working with resonance; voice practitioners vary in their emphasis Like many voice practitioners, I enjoy working to ‘open the resonance’ of someone’s voice because it offers such an immediate change in the sound of a voice, and the person often immediately feels this as different. It is quite possible to use sensory terms such as

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chest or head resonance to refer to sensations that we might feel or hear in those areas, and still understand that the physical realities of those different resonance qualities involve mechanical changes in several parts of the vocal tract: ‘one can argue that it is difficult to control the larynx and its adjustments. It seems easier to manipulate the vocal tract and focus on sensory feedback in producing improved resonance’ (Barichelo and Behlau 2005). A voice teacher may describe a speaker’s tight and rather whining voice as having ‘too much head resonant quality’, because there is an auditory impression that there are too many vibrations echoing around in the nose and sinuses. That sound quality is likely to be formed by a mixture of things, including a lowered soft palate that allows more vibrations to enter the nasal cavities, but there may also be a narrowed pharynx, thin vocal folds, laryngeal constriction and a raised larynx. We might hear a low-pitched, breathy, reverberating voice as having lots of ‘chest resonance’ but, although there may be a few vibrations resounding below the level of the larynx, the main contributors to that quality are likely to be a lowered larynx, vocal folds with a long open phase, an open jaw with wide range of movement, a forward and flattened habitual tongue setting, and lots of lower breath support. These are mechanical settings, and some voice practitioners work primarily on the conscious control of these parts, to create a change in resonant quality. Others will use resonance images as short cuts. ‘Feel the sound resonate through your body from the soles of your feet to the top of your head’ can help a speaker loosen up just those physical structures that are relevant in mechanically creating a more open chest resonant quality. If the sound does not change, specific mechanical exercises can be suggested to encourage that to happen.

The Voice Skills approach uses the term ‘resonance qualities’ So, we can appreciate that vibrations are not physically echoing around the skull, chest, lower back or anywhere else, and still use resonance images and sensations in those areas to increase sensory awareness in voice work. The Voice Skills approach uses the terms ‘head’, ‘oral’ and ‘chest resonance (or resonant) qualities’ to identify three core resonant timbres that can be heard in the voice. The use of the word ‘qualities’ acknowledges that the terms are being used descriptively rather than diagnostically – resonance sound and sensation, not resonance production.

Head resonance quality gives the auditory impression of bright ringing tone, which will carry across noise We may have had the experience of being at a party where there is a constant loud level of hubbub. Suddenly one voice seems to cut through the background noise; we may hear it as rather hard or nasal, or simply as having a particularly clear and ringing tone. As it reinforces the higher harmonics of the voice, it seems to ‘cut through’ the general noise. Its energy is very important in carrying power across space and noise, and for conveying a feeling of form and structure.

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Voice story: helicopter warning recording I was asked to provide my voice in helicopter warning recordings, and playfully imagined I might use a low and breathy feminine tone in phrases such as ‘you’re flying too high, boys’. Of course what was needed was very clear head and oral resonance qualities, to make clear the highly technical warning phrases by cutting through the intensely loud vibrations from the helicopter engine.

Head resonance quality may be created by one or both of two features It is likely that head resonance quality is a mixture of two features, which may or may not occur at the same time: nasal resonance, and the linked qualities of ring and twang.

The nasal resonance aspect of head resonance quality comes from sound vibrations in the nasal cavities Nasal resonance (or tone as it may also be called) refers to the quality produced when vibrations travel past a lowered soft palate into the nasal cavities. We hear it on the nasal sound mm, and on all the sounds in my mummy, as the soft palate does not ‘bother’ to completely close for the vowel sounds. We can also habitually speak with a high level of nasal resonance in all our words, and too much nasal resonance quality, especially when accompanied by too much throat tension, can sound tense, hard and unpleasant. There is often confusion in the use of the word nasal. If your nasal cavities and sinuses are blocked with mucus, people hear that there is something different in your nose and may well comment that you sound ‘nasal’. Even laryngologist Abitbol (2006) writes ‘if you have a cold you sound nasal’; in fact, you will be sounding denasal; the use of the word nasal should be kept for the existence of resonance, not its absence.

Ring and twang are the qualities of head resonance created by narrowing of the epilarynx Titze (2001) refers to both ring and twang, defining ring as the particular resonance created when the epilarynx narrows from front to back, whereas twang is ring with an extra narrowing of the pharynx. I use both terms, but slightly prefer the former term with clients because of its link to the everyday use of the ‘ringing voice’. The sound comes mainly from the mouth, but as Titze says both ring and twang have become associated with nasality, even though the soft palate is usually up. This may be because both ring and nasal qualities have a rather ‘hard-edged’ sound, so our ears mistakenly hear those qualities as nasalised. As we narrow the epilarynx, we may get a sensation similar to when we pull the soft palate down and slightly tighten the back of the mouth, and may feel that we are nasalising the sound. The strong ‘brilliant’ sound of the ringing voice need have no extra nasal tone, but we may choose to nasalise a ringing tone, as does

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the swim-aerobics instructor at my local pool to be heard over the sound of splashes and shrieks in a large space with a hard acoustic. The use of the ring resonance helps a voice to carry without strain across noise or space and, as it is produced by positive muscular tension in the right place (the epilarynx), it lessens the likelihood of inappropriate tension in the more vulnerable vocal folds. It plays an important part in creating the strong voice-carrying power of the ‘singer’s formant’, the resonance quality that enables the solo singer’s voice to be heard above a large orchestra. The ring quality is also a characteristic aspect of the western belt quality and the ‘open throat’ eastern European style of choral singing.

Oral resonance quality gives the auditory impression of articulatory clarity, ‘full’ shaping of vowels and diphthongs, and forward resonance As all voices travel through the mouth, in the literal sense they must have oral resonance. Oral resonance quality is present when the channel shapes vocal sound to have energetic vowel and consonant clarity, and a sense that the vibrations are placed forward in the mouth. If we say that a speaker ‘lacks oral resonance quality’, the sound will be rather muffled, the tongue limited in movement, consonants likely to have poor clarity and precision, the distinctive formant structure of individual vowels will tend to be weak, and there will be an impression that the vibrations are held towards the back of the mouth. They will be ‘deflected off firm-surface tissues back into the nooks and crannies of your vocal tract and they will not be allowed to radiate from your mouth’ (Thurman and Welch 2000).

The notion of forward placing is a traditional voice and singing teacher image and technique The quality of forward placing is very apparent in voices of actors in the films made of Jane Austen’s novels. Practitioners have long encouraged it to minimise throat tension, create clear and energetic speech sounds, and help the sung or spoken voice to carry across space or noise. Forward resonance is created by aspects of vocal tract shaping, particularly by active lip movements and a fronted tongue body position. Practical work enables students to access it through the sense of forward placing, so that they hear the sound and feel the vibrations. Sensory awareness is vital to all voice work, and core to the Kinesensic training developed by Arthur Lessac, voice, speech, singing and movement teacher. Many practitioners in the USA use his ‘Y-buzz’ exercise in the development of strong forward resonance energy, and its effects were investigated by Barichelo and Behlau (2005). They recorded nine newly graduated actors producing a long /ee/ both before and after a thorough session on the use of the Y-buzz. Listening judges were able to identify the post-training ‘resonant voice’ in 74% of the samples, and acoustic analysis showed that there was less irregularity in pitch and loudness, so the voices sounded less rough. The authors concluded that the sound of ‘resonant voice based on the Y-buzz’ can be heard as different and more resonant than normal voicing in the same person, and that it is has better vocal production’. Studies continue to explore the hypothesis that forward resonance reduces excess tension in vocal fold closure, and its use is part of ‘resonant therapy’ techniques.

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Excess oral resonance quality, with a lack of head and chest resonant qualities, can sound prissy, over-precise and thin; when coupled with a slightly high average pitch, it is sometimes the sound heard in the nervous speaker who cannot let her voice ‘drop into her body’.

Overtone chanting involves a specialised balance of head and oral resonance spaces ‘Overtone’ chanting has long been used as part of Tibetan and Mongolian religious practice, and is now taught in the west by some practitioners. The chanter produces a continuous, low, nasalised drone at one steady pitch. At the same time, he shapes lips, tongue, the inside of his mouth and soft palate in such a way that selected harmonics are amplified above the fundamental note itself. He is essentially ‘finely tuning’ the formants so that both a low intoned note and selective harmonic flute-like sounds can be heard. The latter sound very pure, because they themselves are pure sounds with no harmonics.

Chest resonance quality gives the auditory impression that there are sound vibrations echoing within the upper torso This resonance quality is likely to give listeners a sense of warmth, depth, solidity and authority in a voice. When coupled with breathy phonation quality and low pitch, it is the classic ‘sexy voice’. As we have seen, there is considerable dispute about whether vibrations can really resound in the breathing tubes and lungs below the larynx. Some practitioners take the view that this sound is better termed ‘pharyngeal resonance’ because it is produced only by a lowered larynx with more echoing space in a wide pharynx above. Certainly a low larynx position is important for chest resonance quality. There are likely to be two perceptual mechanisms that give an auditory impression of chest resonant quality. At lower voice pitches, it is possible for the bones of the upper chest to resonate in sympathy, in a form of bone conduction. If the voice is produced at a low pitch with the vocal folds apart for relatively longer in the cycle (a longer open phase), it is also possible for reflected sound waves to be passed downwards to bounce around within the trachea below the folds. However, the soft lung walls absorb most of those sound waves, so we do not get a strong ‘echo effect’. Sundberg (1987) describes how we can feel chest wall vibrations only at lower notes, with most at around 180 Hz (F3 on the piano). If the sensation of chest vibration disappears on those deeper pitches below 300 Hz, the singer is probably using a more ‘pressed phonation’. In other words, tightening in the laryngeal region lessens the sense of chest resonance. This relates to exercise 20 in Chapter 22, where a client places his hand on his upper chest, and feels the difference between a tight throat aah and an open throat version. We can produce a reasonably high-intoned vowel and change its auditory resonance quality from oral into chest resonant quality, but we will not feel the vibrations at that higher pitch. Excess chest resonance quality, not balanced by sufficient head and oral resonance quality, can sound ‘pseudo-seductive’, contrived or falsely dramatic.

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Voice study: student Early in his acting training, as he began to release throat tensions, one young student discovered his previously unaccessed chest resonance quality. He liked what he viewed as a lower ‘sexy’ sound quality, and the ‘manly’ sensations within his chest, and started to deliberately use this all the time. It sounded both unnatural and melodramatic. It also created considerable strain as he was holding his larynx down to achieve it. I discussed this with him, and emphasised that, as well as not being his authentic voice, such excess chest resonance quality would not carry past the first few rows of the stalls. Its sound was ‘all boom and no structure’; we need the ring and clarity of head and oral resonance qualities.

The free voice has a balance of head, oral and chest resonance qualities Few vocal performers want to know all the theoretical aspects of resonance, but they do need to be able to open up their resonant qualities, and adapt them to the acoustics of different spaces. In speech science literature the term ‘resonant voice’ is used to suggest the best use of resonance: ‘resonant voice in voice production that is both easy to produce and vibrant in the facial tissues’ (Titze 2001). The Voice Skills approach takes the view that practical voice work aims for balanced resonance qualities to create a vocal sound with mechanical and emotional power. Writers from both arts and science perspectives agree that the effective use of resonance creates the best and easiest voice. ‘The vocal signature is predominantly the domain of the filter system (the resonators). Improved skill in filtering the source signal should reduce the demand on the larynx’ (Carroll 2000). ‘Very few people use their full vocal resonance. . . . The more we can use our resonances the easier our vocal life becomes because we allow ourselves to cut back on effort and tension’ (Rodenburg 1992). The confident voice gives the impression of fully resonating, as if the speaker’s sound comes from the whole of himself, rather than a narrow part. Resonance work is very important for actors, but it is equally important for the nervous presenters, and those who are afraid or disempowered.

Voice practitioners differ in views of ‘good resonant voice’ Over the years I have often heard non-actors say something along the lines of ‘actors always have good resonant voices’. I asked a number of different voice practitioners what they would expect to hear if they were sent someone described as having ‘a good resonant voice’, and end this chapter with some of the varied descriptions received. Voice teacher 1: in a fellow voice professional, I would expect to hear a voice produced with apparent laryngeal ease, on breath, with a good balance of nasal/oral/pharyngeal resonance producing rich harmonics and with an optimum pitch that stimulates plenty of chest resonance. In a non-voice professional, I would expect to hear a voice that might be produced with ease and on breath, but the balance of resonance might favour pha-

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ryngeal harmonics, and the pitch might not be centred but would nevertheless be one that stimulated noticeable chest resonance. Voice teacher 2: I would not use the word ‘good’ but think a resonant voice is probably a voice that sounds like there are plenty of vibrations going on – so an easy comfortable pitch, good range that is appropriate to meaning and a nice open physique – inside and out! Not nasal or constricted, a strong, steady tone and perhaps lower rather than high. Speech and language therapist 1: for me it may be associated with adequate volume, a ‘large’ but not loud voice, with a balance of head and chest without too much breathy quality, probably full fold contact. It will also encompass the psychological resonators and probably evoke pleasant childhood memories. Speech and language therapist 2: I don’t think that I would immediately think of either chest or head resonance, but would expect someone to come in with a naturally powerful voice, an ease of production, an open vocal tract, a rich tone and high intensity without even trying. Singing teacher 1: I would expect to hear a nice vibration or timbre to the sound that appears to be free of constriction. Singing teacher 2: a warm, rich, connected sound.

Chapter 12

Pitch work foundations

Pitch is the most obvious of the variety features in a voice All around us, spoken voices rise and fall in a tapestry of tunes, but we are rarely conscious of pitch unless a speaker has an unusually high or low voice, a monotonous range or repetitive intonation patterns. Speakers often assume that, if their voices lack variation, pitch is at fault. Certainly appropriate pitch changes in a presenting or teaching voice can have a strong effect on whether listeners feel energised. But pitch is only one of five important features of vocal variety, any of which may need practical work in a speaker whose delivery seems ‘dull’: 1. 2. 3. 4. 5.

Pitch variety Loudness variety Use of word and fact emphasis Pace variety Pauses.

These are all prosodic ingredients of spoken communication, and are a vital part of our ability to convey more than the semantic content of the words alone. ‘It’s not what he said – it’s the way that he said it’ is a typical complaint of a listener who has felt the disparity between literal and emotional meaning. Imagine the different ways in which the single word ‘yes’ can be said, in answer to a difficult request. Whole drama game improvisations can be built on such one-word communications and can be good exercises for pitch exploration (see Chapter 23).

In spoken voice pitch work there is often a three-part focus The Voice Skills approach considers three areas that are important when listening to a speaker’s voice: 1. Whether the average spoken voice pitch is appropriate for that person 2. Whether the speaking voice pitch range is right for the speaker’s personality, needs and speaking contacts

Voice Work: Art and Science in Changing Voices. Christina Shewell © 2009 Christina Shewell. ISBN: 978-0-470-01992-4

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3. Whether there is enough variation within the range for the voice to give a sense of interest and energy.

Pitch and frequency have different meanings If we say that something is high or low pitched we are describing an auditory sensation. We hear and recognise that a thin, tight guitar string produces a high-pitched sound, whereas its thicker and looser neighbour string produces lower sounds. The thin guitar string vibrates more often than the thicker one – it has a higher frequency of vibrations and these can be measured. We use the term ‘pitch’ to refer to how high or low a voice may sound to a listener, and the frequency of vocal fold vibrations is the foundation of pitch. But one voiced sound can seem to have a higher pitch than another even if it is at the same frequency. If I crescendo a long intoned vowel staying at the same frequency (say middle C), an untrained listener may hear its increased loudness as a rising pitch. In the ‘resonating ladder’ exercise in Chapter 22 (and on the website) one note is intoned at a steady frequency, but changes in the vocal tract reinforce different harmonics, to give the impression of a movement from high to low pitch. The perceived pitch lowers but the frequency does not. We hear a similar result if I lengthen my vocal tract at the front by protruding my lips while intoning a steady aah; my voice will ‘sound lower’. Pitch is a psychological word that describes our impression of the highness or lowness of a sound; frequency is an acoustics term and can be measured.

Frequency is measured in terms of the number of hertz per second The term hertz – usually abbreviated to the letters Hz – was named after the nineteenthcentury German physicist, Heinrich Hertz. It refers to the number of cycles at which something vibrates each second. In voice, it refers to the number of times that the vocal folds open and close in one second. Normal healthy youngish ears can hear sound waves with frequencies lying between the very low 20 Hz and the very high 20 000 Hz (Denes and Pinson 1993). If you look at Figure 12.1, you will see that the pitch of this upright piano runs from 27 Hz to the high 3520 Hz. Using this figure with a real piano helps identify where spoken and sung voice pitches lie along the pitch spectrum, and can be useful in practical pitch work with individual clients. It actually makes sense to use the piano’s semitones (rather than hertz) to describe vocal pitches, because that is the way that our hearing mechanism recognises sounds (David Howard, personal communication, 2007).

Vocal fold length varies between people In general, the longer vocal fold = slower vibrations = lower pitch. Welch and Sundberg (2002) describe some average lengths for vocal folds, with newborn infants at 3 mm, adult women at 9–13 mm and adult men at 15–20 mm. As men generally have longer and thicker vocal folds, their voices are usually lower than women’s.

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Typical child (7–10) speaking range Typical female speaking range Typical male speaking range

A0 C1 27 Hz 33 Hz

C2 65 Hz

C3 130 Hz

C4 Middle C C5 261 Hz 523 Hz Average child (7–10 years) spoken centre pitch is in this area A3 220 Hz Average female spoken centre pitch is in this area

B2 123 Hz Average male spoken centre pitch is in this area

C6 ‘top’ C 1046 Hz

C7 2093 Hz

A7 3520 Hz

A4 ‘Concert A’ (orchestra tunes to this) 440 Hz

Figure 12.1 Average centre pitches and ranges in speaking – on a typical upright piano keyboard with seven octaves. (Inspired by an original diagram by Howard, 1998.)

There is, however, considerable variation between people. Deeper-voiced singers will tend to have longer, and possibly thicker, vocal folds. Abitbol (2006) says that he has seen bass singers with vocal folds 26 or 27 mm long, and also with 20-mm-long folds. The length of a person’s body is not an indicator of how high or low he will sound, but his body build may be, because there is a significant correlation between neck circumference and vocal fold length (Welch and Sundberg 2002). So, in general, singers with necks like oak trunks will have deeper voices than singers whose heads are poised on slender silver birches; a bass can have a short stature, so long as he has a broad neck!

The average or ‘centre’ pitch is based on the speed of the vocal fold vibrations and can be measured As I talk, my vocal folds continually change length and tension and, over the course of several minutes, they vibrate at a number of different frequencies and produce a number of different pitches. Acoustic analysis can give the mean fundamental frequency of that collection of vibrations, and that will be my average spoken voice pitch for that period. Practitioners sometimes refer to this as the ‘centre’ pitch and, although most do not have access to acoustic measurement, they use their ears to assess whether a speaker’s voice has a high-, medium- or low-centre spoken pitch. Figure 12.1 shows an average male pitch of around 123 Hz, with that of a woman at around 220 Hz. This means that, on average, their vocal folds are opening and closing 123 and 220 times each second (or 442 800 and 792 000 vibrations, respectively, each hour of continuous talking). I sometimes tell clients a little about the astonishing figures for vocal fold vibrations, because it helps to explain why their method of voice production matters, e.g. if a woman

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sings a top C (two octaves above middle C), her folds will be vibrating at an astonishing 1046 Hz. It is impossible to clearly picture those vibration speeds; even the movements of a humming bird’s wings (around 30–50 times a second) can only be seen in a slow motion – not by the naked eye. This is why the use of stroboscopic light to view moving vocal folds has been such an important development, because through its use we can see the vocal folds as if they were moving slowly. The speech science literature gives us information about pitch norms but any figures should be read as ‘in the region of’, rather than an absolute, because they posit a typical average pitch for the groups. Some men may speak with a fundamental frequency of 100 Hz, others at 150 Hz. Women’s voices are usually perceived as female on the phone if their centre pitch is above 160 Hz. However, if a speaker’s centre pitch is in the region of 155– 160 Hz (the E below middle C), and listeners cannot see who is talking, they can be confused about the gender of the speaker. Wolfe et al (1990) looked at whether pitches were judged male or female in 20 transsexual speakers. They played recordings to two groups of speech students and found that a centre pitch of less than 155 Hz was judged to be a male by listeners. These conclusions are important for any work with the transgender voice and, although the use of a computer visual analysis and display is invaluable in such work, a good ear coupled with work on a simple keyboard can still be a good aid.

The centre pitches of women have lowered over time The centre pitches of women vary between different countries, e.g. American women in their 20s have been found to have a generally higher pitch than Swedish women. Changes have occurred over time within cultures. If we watch films made in the 1940s, we may feel that the actresses spoke in a higher pitch than we hear nowadays. This impression has been supported by the research of Pemberton et al (1998). They used recordings made in 1945 of female Australian trainee teachers reading sentences (not ordinary ‘chatting’), and compared them with the voices of a modern matched group. The contemporary individuals were found to have deeper voices than the women recorded 50 years earlier. In 1945, the mean fundamental frequency was 229 Hz (around A3 on the piano), whereas, in 1993, it was 206 Hz (around G3 sharp on piano). Although this is only a semitone drop, if you play those notes, you will hear that it is significant. Pemberton et al speculate that this cross-generational change may be connected to the role and expectations of women in terms of social, cultural and psychological stereotyping.

Some writers talk about optimum pitch ‘Deeply ingrained in the history of therapy for voice disorders is the concept of optimum pitch – that there is a pitch level best suited to the supraglottic resonators that produces the most resonant voice with the least physical effort’ (Aronson 1990). The Voice Skills approach does not use the term ‘optimum pitch’, and takes the view that, if body, breath, channel, phonation and resonance aspects of voice are all working well, a comfortable natural pitch is likely to be the result. A direct instruction to change the habitual spoken pitch should

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rarely be needed. Even for clients who need direct pitch work – the male–female transgender speaker or the high ‘unbroken’ pitch of the puberphonic young man – earlier voice skills will always be addressed first. Telling a speaker to permanently change his habitual pitch level is emotionally and practically disturbing. You can feel this if you use a lower or higher pitch than usual as you describe something that matters to you. However, as a temporary exploration it can be a useful ‘tune-in’ for clients, and can form part of a sequence of pitch exercises. Chapter 23 describes how a keyboard can be used to explore changing a habitual centre pitch.

Alterations in vocal fold length and thickness affect the pitch When the thyroarytenoid muscles in the folds tighten, the folds become thicker and shorter and vibrate more slowly, producing a lower pitch. When the cricothyroid muscles contract, they tilt the thyroid cartilage forward so that the folds become stretched and thinner; these then vibrate faster and produce a higher pitched sound (Figure 12.2). Thurman and Welch (2000) describe how, as the folds become longer, thinner and more taut, they ‘ripple wave more times each second, to produce higher pitches. When they become shorter, thicker and laxer, the vibrations are fewer and lower pitches are produced’. I sometimes use their graphic term ‘ripple wave’ to explain to students the way that the tissues of the vocal fold cover move over its body.

(a)

(b)

Figure 12.2 The thyroid tilt: (a) less tension on vocal folds (lower pitch; (b) more tension on vocal folds (higher pitch). (From Shearer 1979. Courtesy of Charles C. Thomas Publisher Ltd, Springfield, IL.)

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Of course pitch control is central to the work of singing teachers but all voice practitioners use pitch exercises at times. Gliding up and down the pitch range on a vowel may seem like a quick and simple action, but it involves a high degree of fine coordination between breath pressure and vocal fold flexibility. Even the ability to repeatedly intone the same note is a remarkable feat of fine control for ‘every time you sing a specific note, you produce the same length, the same thickness, the same tension, the same elasticity of the vocal cords’ (Abitbol 2006).

High pitches can result from emotional stress As anyone who has spoken when very tense and nervous may know, the pitch of the voice can emerge at an embarrassingly high level. Muscle tension in shoulders, neck and laryngeal area increases, and a frequent result is an increased lengthening and thinning of the vocal folds. If the sternocleidomastoid muscles at the side of the neck over-tighten, they can pull the thyroid cartilage back; the cricothyroid muscle then has to tighten more to tilt the thyroid forward, so the folds stretch and a higher pitch results (Ed Blake, personal communication, 2007). This can also happen if a speaker gets angry. General neck and shoulder release work should always precede work on voice; as relevant muscles release, the larynx lowers in the neck, the gap between thyroid and cricoid cartilages is likely to be wider and the vocal folds can take on a natural length for a lower sound.

Muscle tension levels are highly relevant for pitch Voice story: Jon Jon was a 38-year-old milkman, who had his tonsils removed after three bouts of severe tonsillitis. Tonsillectomy is very painful for an adult, and Jon was still in considerable discomfort when he returned to work after 2 weeks. He became increasingly concerned about the pitch of his voice, which was still unusually high when he saw me 7 weeks after his surgery. His centre pitch was around the level of middle C – well up into the female range. His pitch became even higher if he was tired, or had to speak above the noise of a busy restaurant. Laryngology examination indicated that Jon’s vocal folds appeared normal, but with noticeably excess tension. Jon told me that he was otherwise fit and had a contented family life with no particular stress. When I felt his neck, shoulder and outer laryngeal muscles, they were extremely tight; there was virtually no space between his thyroid and cricoid cartilages, and I suspected that excessive thyroid tilting was stretching his vocal folds. It seemed likely that Jon had developed a pattern of both emotionally and physically ‘bracing himself’ against the experience of his surgery and the severe throat pain, and this had continued even as he got better. We discussed this and I explained the musculature around the vocal folds and how it could ‘over-tighten’. I worked with my hands to loosen Jon’s neck and shoulder muscles and gave him some simple deconstriction techniques. Within half an hour his pitch had dropped to a normal level, and he had no further problems with his voice.

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Different pitches can affect how we feel As with other aspects of voice, the pitch of a speaker can have a strong psychosomatic effect on a listener. A speaker’s excessively high pitch can convey a physical feeling of tension, whereas the low pitch of seduction is at least aimed at giving a sense of a relaxed caress. Many speakers unconsciously use high pitches to energise and excite, and low to calm and soothe. We can hear that contrast between the high pitch mean of many children’s television presenters and the voice that we might use to calm a child at bedtime. The design of the ‘Physioacoustic Chair’ is based on the idea of psychologist and music therapist Petri Lehikoinen who found that low-frequency sounds seemed to provide relief to physically and psychiatrically ill people. He believed that the vibrations had the physical effect of relaxing muscles and resonated with the mitochondria in the cell. The chair provides deep humming low frequencies (27–113 Hz) that can be felt in the body. Its manufacturers report that independent research has found it to improve blood circulation and relax muscle tension in users. Derby County Football club are reported to have 22 chairs in use!

High pitch and high loudness may go together in the untrained voice We can often hear a rise in pitch and constriction when we ask clients to increase the loudness of an intoned note. Separating pitch and loudness is one of the early skills that singers have to learn to control, or every crescendo will make them sound higher and tighter. People tend to raise both pitch and loudness when speaking over high levels of background sound, and this can strain the vocal folds. We may expect young clients to describe some hoarseness after a wild night out in a noisy club, but be surprised if quiet older clients report the same thing after a long car journey. In both cases, there is likely to have been some vocal strain over the background noise. A car passenger’s twisted head and neck posture as she turns to speak to the driver can add to the vocal effort needed to talk over the loud engine noise of older car models. We are not the only species to raise our pitch over noise. Slabbekoorn and Peet (2003) found that Dutch male great tits living in the city sang with a higher pitch than those in the country. They concluded that this has developed so that songs can be heard over the constant low-frequency traffic noise.

The pitch range is relevant to the free voice The pitch range of a spoken voice relates to how high and how low a voice habitually goes in speaking, and how high and how low it can potentially go. The two are usually different; we may be able to squeak like a mouse or growl like a tiger but such pitches are rarely useful in conversation. As we talk, there is usually a constant shifting of pitches to create the intonation patterns for utterances. Occasionally people speak with a very limited pitch variety, giving the impression of a monotonous voice, although true monotone is very rare. We can show a client that our speech has an internal musicality if we hum the tune of a spoken sentence –

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either his or our own. In his 1989 composition ‘Different Trains’, musician Steve Reich notated short real-life speech samples, and set the strings to imitate their intonation; the speech melodies became a powerful shaper of the music. Although we can hear sounds of 20–20 000 Hz, human conversation generally ranges between 100 Hz and 4000 Hz (Abitbol 2006). Spoken voice ranges vary greatly within and between speakers, and relate to personality, social and family culture, current emotional state and where it feels ‘safe’ to talk. Wolfe et al’s (1990) study found that voices judged female generally had more rising intonations and a wider pitch range than those judged to be male. The excitable sociable extravert is likely to have a wider pitch range than the shy quiet introvert, and you are likely to have wider pitch range when you are feeling energetic and optimistic, than on a day when life seems heavy and effortful. So the pitch range norms shown in Figure 12.1 need to be considered in those contexts.

The singing voice pitch range is wider than the spoken one When we were babies we swooped and soared, yelled high and low, and generally reached our tops and our bottoms. Singer Alfred Wolfsohn believed that we all have the potential to sing eight octaves, and his work inspired performer Roy Hart to develop his own extensive vocal range. Sir Peter Maxwell Davies composed the remarkable piece ‘Eight Songs for a Mad King’ for Hart. In this monodrama, the voice shrieks, bellows, growls, cackles, shivers, squeaks, howls and moans in a series of notes across more than five octaves. It is fascinating – and some would deny that it could be called singing. Having studied on a Roy Hart Theatre summer school in France, I know that it can be exhilarating to safely explore these extended sounds. The more conventional singing voice range varies significantly. Confident, classically trained singers are likely to have a wider potential range than avowed non-singers, but even the latter will be able to manage more than they may think possible. Graham Welch writes ‘I have not found an adult female who does not have three octaves. I think that the effect of training is to enable these to be voiced with some degree of comfort and commonality, but untrained voices should still have this potential of generating pitch from a low point to a scream’ (personal communication, 2007). Part of jazz singer Cleo Laine’s reputation has been her range of four octaves, wider than many opera singers. Welch and Sundberg (2002) offer these norms for the different classical singing voice types: • • • •

Basses: 80–330 Hz (E2–E4) Tenors: 123–520 Hz (C3–C5) Altos: 175–700 Hz (F3–F5) Sopranos: 260–1300 Hz (C4–E6).

The acoustic analysis procedure of ‘voice range profile’ or ‘phonetogram’ can precisely plot an individual’s highest and lowest notes at both maximum loud and soft volumes. In general, healthy speakers should be able to comfortably produce at least two octaves in their vocal range without strain. Voice practitioners can use a piano to explore a client’s potential voice range by asking the person to intone vowels and speak sentences at different pitches. If he starts at a comfortable mid-pitch, and moves semi-tone by semi-tone up his

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range, we can hear if there are changes in quality. The same process is then repeated, this time moving down from that middle note. I often use this as both assessment and exercise with singers recovering from vocal fold problems. Slowly working through intoned vowels at different pitches and loudness allows the singer to explore his fine vocal fold adjustments with no need to focus on music, words or emotional meaning. Pitch interval ‘jumps’ can then be introduced to extend the exploration. The ‘pitch slides’ of spoken voice are rarely heard in western classical singing, which has a discrete change from one setting of vocal fold length, thickness and tension to another. In other styles of singing, such as pop and musical theatre, there may well be slides as part of specific and deliberate technique, and they are a common part of the singing style of other cultures.

Pitch variety within the spoken pitch range is also relevant The work of Laver (1980) and the Vocal Profile Analysis Scheme (VPAS) stressed that the variety of up–down movement within a speaker’s pitch range is also important to the voice and the impression of energy it gives. Parameter 6c of the Voice Skills Perceptual Profile (VSPP) is called ‘variety of intonation patterns’ and acknowledges this factor. A person with Parkinson’s disease may find it very difficult to speak with a wide range of high/low pitch contrasts but be able to vary his pitch considerably within a few notes. In ordinary conversation there are usually enough ‘turn-takes’ between speakers to provide a sense of variety, but, in long talks, a repetitive intonation pattern is likely to irritate listeners. If an after-dinner speaker has many sentences with a ‘falling’ pitch line (high to low ‘slide-down’ pattern), the eyelids and energy of his audience may well drop in tandem with his voice. The repeated rising line can be equally irritating. In the last 20 years many English-speaking younger people repeatedly use a rising intonation pattern, as if everything is in a questioning tone. Singers with wide singing ranges do not need to have a wide spoken voice range, but the two often do reflect each other. The use of a wide variety within the range allows a good daily experience of what might be called ‘vocal fold flexibility’ – the length and tension alterations that contribute to pitch change. Speakers vary in their use of pitch and other prosodic aspects and will need to be encouraged to listen to, as well produce, variations in these areas if they want to increase their spoken voice variety. For some people this may be difficult.

Voice Story: Don I was asked to work with Don, a senior designer in a big computer games firm. His manager described him as having mild Asberger’s Syndrome, and said ‘he’s introverted, anti-social and quite eccentric – but enormously bright and motivated in his work here’. The task was to enliven Don’s presentation style, since he sometimes needed to talk to buyers. Although reserved, Don was very willing to work with me. I found he had a

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slightly over-loud voice, and spoke very quickly with very little use of prosodic variety changes. After four sessions I recognised that my failure in the assignment; although he was slightly slower, there was no improvement in pitch variety. Don himself was unworried, and cheerfully reported that he had learnt some valuable core skills of speech organising and the use of audio-visual aids. The HR manager reassured me ‘I think it’s just how he is and we’ve got used to it – he doesn’t have to do big presentations’. Some years later I was interested to read of the research by McCann et al. (2005) into the prosodic abilities of children with high-functioning autism. Their conclusions were that children with autism sometimes have significant difficulty in hearing, understanding and using intonation to express liking and disliking; ‘children with monotonous intonation may sound uninterested in something because they do not know how to express enthusiasm’.

The inclusion of this study is not to suggest that limited pitch variety suggests autism, or that voice practitioners should ever imagine they could diagnose this condition in clients. Rather it is a reminder that a client may need first to recognise changes in pitch, emphasis and rhythm before she starts to produce changes in these voice variations.

Even an apparently steady sustained pitch has slight variations within it If you prolong a sustained voiced eeh sound on one note, you may detect some very slight ‘shaking’ or ‘shivering’ of the pitch level; the note remains at the pitch that you have chosen, but there are tiny higher and lower variations as you phonate. In acoustics, this is referred to as ‘jitter’ and is a normal part of every speaker’s voice. It causes a problem only when there is too much, when the irregularity may be heard as an aspect of roughness. Acoustic analysis can pick up, measure and show the exact degree of jitter.

Vibrato is a regular controlled form of pitch variety The quality of vibrato occurs when a singer makes regular modulation of slight pitch (less than a semi-tone) changes from one core pitch, along with slight changes in loudness. ‘The regularity of this modulation is considered a sign of the singer’s vocal skill; the more regular the vibrato, the more skilled the singer’ (Sundberg 1987). The rate of undulations is generally between 5.5 and 7.5 each second. Fewer will sound like a slow creak, whereas more than 7.5 sounds like a nervous or voice-disordered tremor. Most writers agree that six undulations is the average; Miller (1986) says 6.2 is typical for male and 7 for female voices. He quotes Seashore’s (1936) description of a good vibrato as ‘a pulsation of pitch usually accompanied by synchronous pulsations of loudness and timbre, of such extent and rate as to give pleasing flexibility, tenderness and richness to the tone’. We may speculate on why these slight variations are considered to make the sound richer and more emotionally interesting, but our conclusions would probably be as varied as the

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explanations for the mechanics of vibrato. Welch and Sundberg (2002) differentiate between frequency vibrato (changes in pitch as a result of pulsations in cricothyroid muscle) and intensity vibrato (slight loudness variations as a result of changes in vocal fold amplitude). Mathieson (2001) writes that the cricothyroid pulsations are accompanied by fluctuations in the soft palate, back of mouth, epiglottis and side walls of the lower pharynx, whereas Sundberg (1987) also suggests that the vibrato type sound in western pop music is likely to be due to pulsations of subglottic air pressure. Davies and Jahn (1998) quote Hirano, who found that there were rhythmic changes in the tension settings of the cricothyroid, vocalis and lateral cricoarytenoid muscles, and add that it may also involve rhythmic motions of the tongue, the floor of the mouth and the pharynx. The ‘bleat’ quality occurs as part of Indian classical singing, many eastern European styles, and some aspects of the folk and ‘ethnic’ style. Singer Dinah Harris (in Harris et al 1998) defines this as a fast vibrato with a high variety of intensity; in classical singing it is an unwanted feature if it appears as a result of excess muscular tension.

Chapter 13

Loudness work foundations

Our perception of vocal loudness involves more than a simple decibel judgement A voice needs to sound loud enough to both listeners and speaker, but this is affected by more factors than the ‘bigness or smallness’ of the sound. Loudness is near the end of the Voice Skills chronology because, if other voice aspects all work well, a speaker with a quiet voice can come across as vocally strong. It is quite possible to produce a loud voice with patterns of excess postural and laryngeal tension, and this often happens if a speaker is simply told to ‘speak up’. The word loudness refers to our perception; we measure the intensity of a sound in terms of its decibel level. The Voice Skills approach identifies three aspects of loudness: 1. Vocal energy: the general decibel level 2. Loudness variety within a voice 3. Loudness focus: the ability of a speaker or singer to project that energy where needed.

Loudness relates to the amplitude of vibrations Amplitude refers to the amount that an object moves as it vibrates. A barely vibrating guitar string will produce a quiet sound; if it is strongly plucked it starts to move much more, and the sound is heard as louder. Larger amplitude creates more intensity of energy, and this can be measured in decibels. The amplitude of the vibrating vocal folds refers to the extent that they open from their rest position; in quiet voice the folds do not open very much, whereas in loud voice they open widely. Their amplitude of vibration affects the energy of the sound waves. The complexity of sound waves is beyond the scope of this chapter, but it may be of interest to those who perform outside in varied weather conditions that sound waves travel faster in warm air than in cold. So your voice may feel as if it can travel further and more easily on a warm summer evening than a cold one. The composition of the air also affects sound wave behaviour. This is relevant if someone speaks on a little inhaled helium from

Voice Work: Art and Science in Changing Voices. Christina Shewell © 2009 Christina Shewell. ISBN: 978-0-470-01992-4

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a balloon, and produces a high voice like a cartoon character. Sound waves move much faster in helium than in ordinary air (1300 m/s in contrast to 317 m/s) because the helium is less dense. The vocal folds have less resistance, sound waves travel faster and the lowpitched harmonics disappear (Abitbol 2006).

Loudness is created by breath pressure, and wide opening and closing movements of the vocal folds with firm closure The higher the air pressure under the vocal folds (subglottic air pressure), the louder the voice can be. An increase in airflow blows the folds wider apart during a vibratory cycle, resulting in a sound pressure wave with bigger amplitude. In loud voice the folds usually have a longer closed phase than in quiet voice. Higher pressure usually means tighter closure, but this should not be excessive. If there is less air pressure, the vocal folds will have smaller amplitude of vibrations (less movement in and out) and the sound is likely to be softer and more breathy. Appropriate breath power is needed to power a safely strong voice; people may otherwise try to get that firm vocal fold closer by excessive laryngeal muscle tension. A simple way to demonstrate amplitude is to clap your hands. Keeping the same tension in the hands, first put them widely apart and clap, and then bring them nearer to clap. As you will hear, wider apart makes louder sound, closer makes a softer clap. Performers are discerning in judging audience approval by the amplitude of their applause!

We can measure the intensity of a sound produced by the amplitude of vibrations The intensity of sound is measured in ‘bels’ – named after Alexander Graham Bell who invented the telephone. One decibel (dB) is one-tenth of a bel; Denes and Pinson (1993) explain that ‘the decibel scale allows us to compress an enormous range of intensities into manageable proportions’. This is needed because the loudest sound we can hear without pain is around 130 dB, which is 10 million million times greater in intensity than a just audible sound. Table 13.1 shows some typical decibel levels for the sounds around us, and for various levels of our own voices.

The loudness of the background noise affects our own voice loudness levels Davies and Jahn (1998) say that a speaker’s voice should be 35 dB louder than the background noise in order to be clearly heard. To be heard above many of the background noises listed in Table 13.1, we would have to speak considerably louder than our normal conversation level. The high sound levels of some nightclubs explain why people may feel real vocal strain as they try to make themselves heard. Vilkman (1996) reports that the sound level of the speaking voice increases with 3 dB for each 10-dB increase in background

Loudness Work Foundations 197 Table 13.1 Typical levels of different noises.

The sound

Typical decibel level (within 2 m of sound source) (dB)

Rustle of leaves Whisper (at 1 m) Quiet speaking Normal conversation Loud shout Restaurant background noise of mass loud conversation Loud TV Heavy traffic in street Sound level inside noisy car Sound level inside noisy aeroplane Limit for prolonged exposure recommended by the Occupational Safety and Health Association German urban nightingales singing Orchestra playing Beethoven Ninth full volume Some background nightclub music The sound of an aircraft taking off Very loud scream Pneumatic drill Level at which we begin to feel sound, as well as hear it Loud rock music band The Wick Highland Pipe band players in rehearsal space 2000 European Scream Champion Strongest sound that we can hear without pain

12 20 35 60–70 90–110 60–80 70 80 80 80–85 85 93 105 110 110 120 120 120 120 122 126 130

Compiled from: Denes and Pinson (1993), Davies and Jahn (1998), Mathieson (2001), Ash (2005), and various media reports.

noise starting from level 40 dB. So, if a classroom noise level is between 75 dB and 80 dB, the teacher’s voice has to be at least 92 dB, which is above the limit for prolonged exposure recommended by the OSHA (Occupational Safety and Health Association). I sometimes quote the example of German urban nightingales in Table 13.1 as a little light relief to clients, because the implications are that it may not just be humans who need to look after their vocal health. Brumm (2004) found that nightingales living near the noisiest traffic routes sang 14 dB louder than in quieter parts of Berlin, and were technically above the legal sound limit. Brumm commented that, although it was unlikely that they developed laryngitis or sore throats, the birds’ volume level meant a five times greater pressure on their lungs, and ‘it may still cost them’. Although birds are well adapted to singing ‘maybe like an opera singer they get tired singing at the top of their voice’.

Our level of vocal loudness can affect laryngeal health Most of us know the feeling of strain if we shout too loudly at a sports or music event, scream during an emotional row or raise our voices against loud sounds. Research evidence

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supports our sense that this is not good for our voices. Aronsson et al (2007) found clear evidence that speakers increase both pitch levels and subglottic air pressure when trying to make themselves heard over background noise. Those who already had vocal nodules used more pressure than those who did not – a strong indication of how important it is for those with voice problems to avoid noisy environments. The voices of singers and actors are usually trained to be heard without amplification, who know that they cannot always rely on the existence or adequacy of a sound system. But even actors can develop voice problems if they ‘shout badly’, and any untrained speaker may feel a sense of strain in the voice or even develop a more serious voice problem if he uses loud voice with inadequate support skills. Voice practitioners can play an important role in protecting the voices of those whose voices have to be loud on their working environment, such as the ‘Caller’ group of professional voice users, described in Chapter 28.

We can learn safe loudness Words such as ‘call, shout, bellow, yell, shriek, howl and scream’ refer to slightly different qualities of sound, but they all involve high energy and a high loudness level. Actors and singers may need to do all of these – and to sob, cackle and laugh with varying emotional intensity for eight shows a week. There are very specific techniques to help them do this without damaging their voices, and some voice teachers have special expertise in this area. In a modified form, some of these techniques are highly relevant for anyone who regularly has to sing or speak at excessively loud volumes. A brief list of contributions to safe loudness include: • • • • • • • • • •

Good body alignment and strong bodily anchoring ‘Warmed-up’ muscles with no excess tension Lots of vocal tract moisture Lower breath placing for support Adequate in-breath before the strong voice Released jaw and relaxed tongue. No excess laryngeal or pharyngeal constriction An ability to use the ring quality Head resonant quality and forward resonance Some practice gliding loudly up the pitch range, from low to high on an eh sound, with a long, loud, intoned – almost sung – sound at the top • Strong consonants in articulation • Afterwards – if the situation allows – a vocal and physical cool-down, e.g. limb loosening, big chewing movements, humming glides down the pitch range.

Being loud can be exhilarating Safely done, it can be exhilarating to voice loudly. Sylvia Townsend Warner wrote ‘I found that of all things I loved making rude remarks at the top of my voice and that the top of my voice was gratifyingly rude and nasty’ (quoted in Harman 1994). A journalist said ‘shouting means energy, and energy means great headlines’. A newspaper report described research that found that there were physiological and physical benefits of screaming, with

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individuals being less stressed, more energetic and sexually more enthusiastic after a ‘full throated’ scream (Anon 1999). Voicing loudly can make us feel powerful, energetic and expansive. Folklore and myths describe the potentially transformative power of strong breath and loud sound. In the Baba Yaga story the hero is given three horns; he has to blow the first quietly and the second more loudly, and is told to blow the third ‘with all his energy’, i.e. his whole self. When he does this, he summons up the great Firebird, who will do what he wishes. Mass sports events and rock concerts offer adults a context where it is socially acceptable to shout or sing as loudly as possible, and that is part of the excitement of these events. In June each year, in the small hamlet of Spivey’s Corner in North Carolina, thousands of people gather for the National Hollerin’ Contest. Contestants call as loudly as they can and are judged on volume, length of call and intonation. It is an interesting reminder of American heritage, when in pioneer days settlements communicated with shouts that could be heard up to 3 miles (5 km) away. There is evidence that such loud communicative vocal sounds have existed for centuries around the world. Shy, frightened and disempowered individuals often find it very hard to be loud. In voice workshops I often try to allow a period where people can safely explore very strong vocal energy, and experience the upper limits of their own loudness. This can lead to emotional release, but also gives some practical skills. People can learn how to reach that quality safely if they want and need to do so and, equally important, they can use some aspects of those skills in less loud but strong ordinary voice.

Often people are unaware of habitual loudness level Sometimes the voice practitioner has to help a speaker to recognise that his habitual volume level may be contributing to a voice problem or to a limitation in relationships. That client may benefit from finding a way to monitor himself, and from explorations in ways to be louder or softer, while still feeling true to himself. It can be difficult. The man with the very quiet voice cannot believe that raising his volume just a little bit does not sound like an aggressive shout. The woman with the continuously over-loud voice does not recognise that she is too loud for comfort, feeling that anything quieter will sound weak. Feedback from a group can be of real help here, as can the on-going awareness of the ‘Loudometer’ image (described in Chapter 24).

Voice story: Danny Danny had a mild learning difficulty, and for several years he had worked in a big hardware store. However, both his family and his employer found that his voice was often inappropriately loud and sometimes unwittingly offended customers. Although I used a computer software program to show Danny how his voice could be at different levels, the real difference was made by his willingness to take on board the idea that he needed to bring his loudness level down from a 5 or 6 to a 4. He wrote the number 4 on his hand, and this simple reminder was very effective in helping him to gradually adapt his vocal level until it was far less ‘big’.

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Loudness variation is important in public speaking Any public speaker needs a variety in loudness, to reflect the emotional meaning and context in which she is speaking, and to give a sense of different energy to listeners. That flexibility is one of the sometimes forgotten aspects of vocal variety. Most politicians, and others who address large groups, know that mono-volume shouting, declamatory style, is not as effective as the use of subtle variations. E. Amy Buller’s (1943) description of different Nazi speakers demonstrates this. ‘Most of our time was spent in what surely must be the biggest hall in the world, while Nazi orators – quite certainly the coarsest and ugliest in the world – blasted forth unending speeches and hysterical crowds drank in their poison. I was interested to discover that Goebbels was by far the easiest to listen to and for this very reason, perhaps the most dangerous. His voice did not wear us out as the harsh voices of the others did, and the tortuous sinister workings of his mind had their interest.’ Actors have to learn to speak loudly enough for a theatre but still sound natural and truthful, and that can be hard. Film can be easier. In an interview Peter Brook (Kustow 2005) said ‘every actor knows that the quieter he speaks, the closer he can be to himself – and when you play Shakespeare in close-up in a film, and have a mike, and can really speak the verse as quietly as this, you’re not going against the nature of verse, you’re going in the right direction, because you are really allowing the verse to be a man speaking his inner world’.

The use of emphasis is important Word and point emphasis is like using bold typeface or underlining or CAPITALS in writing – it alerts the reader listener to PAY ATTENTION AND TAKE IN. It involves more than loudness, because pitch change, vowel length, consonant energy, pause and even a change in phonation quality may all signal the need for attention. But loudness is an important component, and we need to be able to use light but definite ‘pulses’ of loudness for the key words in a sentence. ‘Our company will not capitulate, it will negotiate.’ It is tedious if overdone, and can be misused; one public speaker had marked on his script ‘weak point – shout here’. It is also an important tool for clarifying meaning. In my study of the subtle communication skill differences between Indian and British business people, I was interested to discover the importance of word emphasis to mutual communication. To emphasise a point, British speakers tend to use an extra pulse of loudness and often a pitch change; the American pattern is often just to use increased loudness. The Indian business people in Mumbai spoke fluent English, but generally the flow of speech was fast and even, with much less use of any word stress than the average British or American speaker. If this were coupled with a rather heavy accent, the British listener tended to have trouble understanding what was being said, because there were no ‘emphasis’ pointers to direct him to the most important words (Shewell 2000a). Direct training on the spoken highlighting of important words, along with the use of pause, made a significant difference to how well one young project manager was understood in the English office.

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The ability to focus vocal energy is an important part of voice projection The word focus in this context refers to a speaker or singer’s ability to ‘send’ his voice and inner energy to where he wants it to go. It is not the same as the overall loudness level and cannot be measured. It can, however, be sensed; we may be able to hear a speaker as we sit in the back row, but have the feeling that the focus of her energy drops in the middle of the room before it reaches us. It is easier to demonstrate than explain, because, although connected to certain technical skills, it also links to less tangible factors such as intention, clarity of thought and relationship to the listeners. In a group workshop it is helpful to show the difference between good and poor energy focus, before practical exploration in imaginative, physical and skill-based work. The technique skills are those of voice ‘projection’, a term currently unfashionable among some voice practitioners. This is probably because it has connotations with the worst aspects of elocution, with an over-emphasis on ‘push’ and rich, forced vowels. I should like to rehabilitate the term, because its dictionary definitions include words such as ‘throw out, extend, and stretch out’ and all are appropriate images for the voice that carries across space and sound. Certainly ‘projection’ implies focus. The voice should feel as if it is streaming and stretching out from the mouth to reach wherever it is needed, no matter what the space or acoustic. When actors first move from the rehearsal room to the theatre stage, the change in acoustic can be a shock. Voice teachers use a range of techniques to help that transition, including exercises to ‘breathe in’ the space, sending intoned vowels into different parts of the auditorium and walking around the whole area while voicing.

Projection also involves energy and variety, and there are a number of relevant voice skills Although several have been described in previous chapters, this is the kind of summary that can be given to a public speaker who needs to ‘spread and focus’ her voice. Specific exercises for each are described in Chapter 24: 1. The body: if standing, it helps a sense of stability and symmetry if the feet are solidly connected to the ground with equal weight distribution, hip width apart and pointing forwards not out. The head and neck need to be well aligned, and there should be a sense of a ‘long back’, with no raised, tense or hunched shoulders. If sitting, the lower back should be in contact with the chair back, the spine lengthened, and check that your head is not poking forward and that the shoulders are dropped. 2. The breath needs to be low placed, and capable of a long enough outflow to power both short and longer utterances with power and variety. The abdominal muscles need to support the sound as it comes out, with more movement at high loudness levels. 3. The channel: Face: animated faces are easier to ‘read’ than expressionless ones, but this should not be over-done. Lips: more movement than usual helps bring the vibrations forward in the mouth, shapes the words and can also enable people to get clues from lip-reading if necessary. Outside, the wind can literally blow away sound vibrations, and internal bad acoustics or background noise can muffle the carrying power of words.

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4.

5. 6. 7.

8. 9.

Jaw: should be relaxed and reasonably open, with an appropriate range of movement. Tongue: needs to be energetically mobile in order to shape speech sounds. Consonants need to be crisply articulated with good contact between the active and passive articulators in the mouth. Vowels and diphthongs need to be well shaped; if the tongue just ‘sits’ in the central position of the mouth with little movement, all the vowels will move towards sounding like the /ə/ vowel, and speech will be correspondingly less intelligible. Pharyngeal/laryngeal area: a sense of the ‘open’ throat, with no excess constriction, but an awareness of how to use the epilarynx area for ring if necessary. Resonance: a balance of head, oral and chest resonance qualities works best. Occasionally the use of slightly more head resonance than usual can help carrying power. There also needs to be a sense that the vocal vibrations come forward to the front of the mouth. Pitch – intonation: there needs to be enough rise and fall in the voice to clearly ‘mark’ the tune; this helps to carry the meaning of the sentences. Loudness – word emphasis: key points and words need to be stressed appropriately, to signal their importance to the listener. Articulation: all consonants should be more energetic than usual, and a very slight lengthening of the vowels can help carrying power. Speakers – and singers – so often forget that, although they know the words, listeners may have never heard them before. Speed: should be slower than usual, but still with variety. Pauses: these are important to allow the sound to settle and the meaning to be absorbed; the human brain likes time to hear, interpret and ponder words.

Chapter 14

Articulation work foundations

In this eighth voice skill, the term articulation has a wider brief than its traditional definition of the pronunciation or diction of speech sounds, and includes six other aspects of the way that words work in connected speech: 1. 2. 3. 4. 5. 6.

The use of individual words Speech sound clarity Pace Pause Fluency Rhythm.

The use of individual words Words in normal communication: word choice and word filling Word choice refers to the way that a voice teacher may help a public speaker with phrase and vocabulary selection in writing or rewriting parts of a speech to create the maximum impact. (This chapter considers the ‘normal’ use of words; some speech and language therapists work with children or adults with developmental delay or damage to the language area of their brains – a highly specialised area of work.) Word filling describes the way that a speaker’s or singer’s whole voice can make a word ‘resound’ with its meaning. This ability to connect to and express the deep inner resonance of words is a subtle skill, and an important part of actors’ training. It happens when there is a deep connection of speaker, words, voice and emotion. Although not easy to explain, it is felt, when we hear dramatic text or poetry spoken so well, that it has a strong emotional–visceral effect on us. We recognise it in the actor who seems at one with the text of her character, in a powerful speaker who seems to make every word come alive or when a singer deeply communicates the meaning of his song.

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A speaker has an enormous potential vocabulary from which to choose The normal speaker has potential access to a huge range of vocabulary items from her own native language. R. Lederer (in Ehrlich 1997) writes that the English language has 616 500 entries in the Oxford English Dictionary but even the ‘most articulate verbivore interacts with only one-sixth of our English word hoard and actually employs only one-sixth of that’. He estimates that the average English speaker has a usable vocabulary of 10 000–20 000 words, but regularly speaks only a fraction of that, the rest being used in recognition only. To mark its seventieth anniversary in 2004, the British Council asked 40 000 foreigners in 102 English-speaking countries for their favourite English words. At the top of the list were words with important emotional meanings, such as mother, passion, smile, love, eternity, fantastic, destiny and freedom. Also included were words that simply ‘sound good’ – bumble bee, flip flop, peekaboo, whoops, zing and hiccup. Words are powerful. Some prominent public speakers use speechwriters, who choose the best expression of a message for each context. Most ordinary people write their own speeches, and may not recognise that the apt use of a particular word or image can powerfully affect the intellects and hearts of listeners. In rare cases it can change the course of a life. Writer Rose Tremain described how she first met her husband at the Adelaide Book Festival in 1992. She asked how they might recognise each other, and ‘he said the sweetest thing: I am bald and bespectacled and I will be foolishly smiling. And I thought that was such a lovely sentence that I probably fell in love with him then’ (interview with Susanna Rustin 2003). Some coaches use poems to connect speakers to the use of vivid expression, and stimulate ideas for rephrasing to create memorable images. After such work, the chairman of a fashion company rewrote the final sentence of his speech to the board in his own words. It moved from the mundane: ‘we need to encourage further investment if our company is not to face limitations which will affect its performance next year’ to ‘at the moment our investors are shivering like elegant flamingos on the edge of a cold lake; it is our job to give them the water wings of confidence so they can plunge into the water – and find it rejuvenating!’. Of course words need to be chosen carefully, because a false and self-conscious impression can be given unless they feel as if they ‘belong’ to the speaker and the context. Imagery in speeches is not always appropriate for every audience. A politician told me about a colleague who prided himself on his vivid use of language. After talking to a group of farmers, he asked his host how it had come across. ‘Well’ came the straight reply, ‘ten minutes of rain would have done more good’.

Speakers can develop their skill in ‘filling the words’ Voice and word are intimately connected. ‘The voice constructs itself, becomes richer, is kept alive thanks to our verbal past. The transmission of the intangible word is the secret power of our knowledge base. Pregnant words, rich in meaning, are the genetic units of our intelligence’ (Abitbol 2006). We need to connect to what we are saying. It is possible to read a page out loud and not register what one has read, and a listening audience is likely to sense this on some level.

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Those who have to bring alive another’s words can most deeply communicate the word if they can feel and fill it. ‘The mistake has been the banishment of words from the body’ (Linklater 1976). To fully release that meaning we need to be able to sound the words, by using the weight and clarity of consonant and vowel to express that inner meaning. ‘This is not just done by greater sharpness but by carrying the intention through the vibrations of the vowels and the consonants, being aware of the physical movement of the words and making them reach’ (Berry 1987). We do not know how words started, but in the onomatopoeic words of all languages we can see the way that a sound was imitated in a vocabulary item – classic English examples are ‘crash, cuckoo, sizzle, click’. More words than we realise have a kind of inner resonance, in that the speech sounds seem to reflect the meaning. In a voice workshop we coined the term ‘logosensopoeia’ to mean a word where the sensation of its sounds gives us access to aspects of its deeper feeling meaning. Contrast the sounds of ‘kiss and kick’, ‘quick and ramble’ and you may sense the idea.

Speech sounds vary in their phonetic power The field of speech science offers some findings that may relate to the ‘sound power’ of words. Bakén and Orlikoff (2000) describe how some speech sounds have more intense ‘phonetic power’ than others, correlating with factors such as pressure inside the mouth and force of articulation. Vowels are ‘the most intense’ phonemes but they vary in power, with /ɔ:/ and /a:/ more powerful than /u:/ and /i:/ for instance. Consonants are weaker in intensity than vowels but again differ – /r/, /ʃ/, /ŋ/ and /m/ are more acoustically powerful than /b/ /d/ /p/ and /f/. The sound /θ/ (the voiceless th) has the weakest intensity of all. If you make a long /ʃ/ (sh) and then a long whispered /θ/, aiming for the same loudness level, you will hear which is inherently more intense. Poets and writers instinctively exploit the power of sounds in their work. Along with their semantic meanings, it is that ‘group sound effect’ of words that plays a part in the emotional and intellectual effect of text.

Some believe that speech sounds affect our emotions There is a belief that different speech sounds can create different emotional sensations and states of consciousness, and spiritual traditions have utilised this idea in their practices. Rudolph Steiner (1960) described how the sound of vowels reflects ‘some inner feeling of the soul that may be experienced in connection with the world outside’ whereas consonants ‘imitate, in the very way the sound is formed, some external object, being or process’. So, for instance, the sound /i:/ is said to express joy in the assertion of our sense of self, whereas /n/ expresses a lightness of touch. Although the Steiner approach is not part of my own work, it is interesting to see the different feelings that the group ‘Sound Bath’ exercise (see Chapter 26) evokes in those who are sitting surrounded by a circle of people intoning a vowel over their heads. Listeners vary in which vowel sounds they like or do not like, but a long /a:/, /i:/, /u:/ or /ɔ:/ appears to elicit quite distinct feelings in those who impassively hear them.

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Speech sound clarity Phonetics is the study of speech sounds Professional phoneticians are experts in the way that speech sounds are produced, how they work within and between languages, and how they relate to the prosodic aspects of language. It is a huge field, with an extensive literature and research. There are also a wide number of approaches and books relevant to the practical work of changing speech sounds, in both artistic and clinical settings. The following are the main two aspects of speech sound work: 1. Practical speech muscle work for clarity, speed and energy 2. Remediation of speech sounds that are produced incorrectly.

All voice practitioners work with speech sounds Voice teachers know that the speed, clarity and energy of speech sounds are essential tools in the expression of any text. ‘The perception of the length and movement of the vowels, and the length and vibration of the consonants . . . it is this that keeps the language always active and muscular’ (Berry 1987). In stage work the actor needs strong tongue muscularity and an open jaw setting, with adequate range of movement in both. If the jaw is close and moves little, all speech sounds will sound muffled. If tongue movement is limited, diphthongs will tend to sound like single vowels – so our house (RP /aυə haυs/) might sound more like more like ah herss (/a: h:s/). This may be quite appropriate for an actor in a naturalistic television drama, but creates a flat sound if he is speaking the heightened text of poetry or classical drama. Even in films, speech sounds need to be strong enough; Churcher (2003) describes a range of good ideas relevant to voice in this medium. Microphones amplify speech but they do not clarify it, and filmgoers sometimes have to struggle to hear what an actor is saying. In public speaking, a presenter may be easily intelligible but a pronunciation pattern of weak soft contacts in lip and tongue tip plosives (b, p, t, d) can contribute to a lack of carrying power, and may give a feeling of low energy or clarity of mind. Singing teachers know that the most beautiful vocal notes need to be matched by the diction needed to sound the words as well as the music. A choir can make a thrilling collective vocal sound but, if the audience can hear few words, the meaning of the songs is not fully communicated. Consonants give a structural framework around the vowels and can be important in conveying an impression of energy. Bob Dylan (2004) describes the singing of Woody Guthrie: ‘his voice was like a stiletto . . . he would throw in the sound of the last letter of a word whenever he felt like it and it would come like a punch.’

Changing defective sounds needs a specialist approach SLTs are trained in techniques to treat children and adults who have speech sound problems due to developmental delay, hearing impairment or neuromuscular damage. Any speaker or singer with a significant speech sound problem should be referred to a therapist. A voice or singing teacher may improve milder speech sound problems, but considerable knowledge and

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skill are still needed. The hissing sound of an over-sibilant /s/ can ruin an actor or broadcaster’s delivery, as can the soft /s/ of the mild lisp or the weak /r/, which may sound like some version of a /w/. They may seem small aspects of voice but remediation involves a change in long-held habits of neuromuscular pathways from brain to speech muscle. It needs a step-bystep approach from a high level of awareness of where and how a sound is being made, through carefully structured specific tasks tailor-made to the individual. The work can be fun, but permanent change needs hard work, motivation, commitment and regular practice. Some SLTs run courses in direct work on speech sound remediation for voice and singing teachers; Annie Morrison’s ‘Creative Articulation’ is included in the website list.

The IPA chart is an invaluable tool for voice practitioners Throughout this book you will have seen letters or symbols written within slant lines to describe vowels and consonants. These are part of the International Phonetic Alphabet (IPA), taught in all SLT and formal voice teacher training. This very valuable tool provides a symbol for the consonant and vowel sounds of every language, with each specified according to whether or not it is voiced, its place and its manner of articulation. So, for instance, /v/ is described as a voiced labiodental fricative; its sound is made by voiced friction passing between a narrow channel between top teeth and lower lip. Phonetic symbols represent sounds not letters, and so avoid the vagaries of the spelling of a language, e.g. the phonetic symbol /f/ represents the sound that we find at the start of fish, but also the sound at the end of rough. The symbol /i/ is the sound we find in both hit and women. The IPA system also has a number of extra diacritics to specify further details about a sound. The full IPA chart and sound recordings can be found on the website for the International Phonetics Association. Box 14.1 gives an idea of the symbols used for some English consonant sounds.

The cardinal vowel chart Vowels are the main vehicles for the overall sound of a voice, and the tongue’s movements are crucial in creating the different formants that distinguish one vowel from another. An example of the way that a small change in tongue position can confuse two vowels and change word meaning came in a recent production of Arthur Miller’s ‘The Price’. The character Walter is asked ‘What did he do?’. His answer – core to the scene – is ‘He laughed’. In this particular show, the British actor overdid the American accent so it sounded like ‘He left’, which confused the audience until clarified by the next few sentences. The cardinal vowel chart was systematised by phonetician Daniel Jones, and provides a way of identifying and mapping how the tongue and lips produce any vowel. The shape of the chart in Figure 14.1 represents a left-side view of the inside of the mouth. The cardinal vowels, round the edge of the chart, show eight positions where the tongue would be in four front-of-mouth settings and four back-of-mouth settings. For both back and front, the tongue may be close to the roof of the mouth, mid-close, mid-open or open, and the lips may be rounded or unrounded, e.g. if you put the front of your tongue as close as possible to your alveolar ridge and make the ee vowel with spread lips, you are likely to be

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Box 14.1 International phonetic alphabetic symbols for English (RP) consonants pen, spin, tip: /p/ but, web: /b/ two, sting, bet: /t/ do, odd: /d/ chair, nature, teach: /tʃ/ gin, joy, edge: /d / cat, kill, skin, queen, thick: /k/ go, get, beg: / / fool, enough, leaf: /f/ voice, have: /v/ thing, teeth: /θ/ this, breathe, father: /ð/ see, city, pass: /s/ zoo, rose: /z/ she, sure, emotion, leash: /ʃ/ pleasure, beige: / / ham: /h/ man, mummy: /m/ no, tin: /n/ singer, ring: /ŋ/ left, bell: /l/ run, very: /r/ yes: /j/

approaching the sound of cardinal 1 – [i]. You would probably not normally pronounce it like that, but have produced a ‘reference point’ sound. The chart can be used to ‘map’ the tongue, placing for the vowels of any language or accent. If one speaker has a Liverpool and another a South African accent, their sweet vowel would appear at different places on the chart.

There is no one best regional accent Received pronunciation (RP) has long been used in phonetics as a general standard with which to compare other accents. Although supposedly emotionally neutral, it has inevitably had attached stereotypes and expectations. Considered the accent of educated southern English speakers, it was for many years the compulsory accent of British national radio. It is appropriate that radio demands have now changed, because regional and national accents provide colour and variety to any language. Actors and singers have to learn to use ‘standard English’ (the term generally used in the arts world for RP) as a tool of their trade, but are no longer expected to stop using their own accent in ordinary life, as used to be requested by some drama schools.

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Figure 14.1 The first eight cardinal vowels.

For any speaker, what matters is that the words of any accent are intelligible without effort by listeners of any other accent. We do not aim to make a Glaswegian speaker sound as if he comes from southern England, but we might suggest that he release any tight jaw tendency, to open up some of his vowels and increase audibility. Members of the general public do not always appreciate the difference between voice and accent, e.g. a newspaper article reporting on a patient who had had vocal fold surgery to make his voice sound younger felt the need to point out to readers that he still spoke in his native New Jersey drawl.

Foreign language speakers may want specific work to improve the accent of the target language Many voice teachers work with foreign language speakers on their accent, because this is clearly a very important aspect of language acquisition. A simple chart along the lines of Box 14.1 allows all consonants to be checked and charted, whereas Table 14.1 shows material that can be useful in both the assessment of vowel pronunciation and their practice. Such a list cannot be seen as ‘fixed in stone’ because the everyday pronunciation of RP vowels continues to change. Diphthongs are often simplified. Fifty years ago a company name such as ‘Tower Car Hire’ would probably have been spoken as /taυwə ka hai ə/; in today’s younger speakers it is likely to sound like /ta ka ha:/ (Evelyn Abberton, personal communication, 2008).

Voice story: Zorlu Zorlu was a Turkish lawyer who had come to live in this country and wanted to develop his career as a barrister. He was concerned that his Turkish accent had a negative effect on his immediate intelligibility with both colleagues and clients; he did not want to disguise his nationality, but he did want to sound more Anglicised. I asked him to read aloud the RP English vowel material and noted the most obvious variations. Box 14.2 shows the summary of these, and provided a clear target from which we could plan a programme of listening and production work.

210 Voice Work: Art and Science in Changing Voices Table 14.1 English vowels practice material: practice material for vowels in received pronunciation (RP) and other English accents.

Symbol

Place in RP

Words and sentences

Long vowels i:

Front close

bee, feed, leaned, feel, wheat, eager, heater Please eat the peaches and cream We need to clean these green heaters

:

Central

fir, curve, heard, turned, murmur, word They searched for her purse in the ferns It’s the early bird that catches a worm

α:

Back open

are, large, barn, calmed, martyr, sarcastic Charles’ heart is far harder than Mark’s The car was parked in the farmyard

ɔ:

Back mid, rounded

door, sword, roared, warm, order, daughter Walk to the door in the north porch Draw the stork on the chalk board

u:

Back close, rounded

do, new, tube, moon, cool, loser, useful, boot Do choose the goose soup, you two Hugh was well groomed, moody and aloof

Short vowels i

Frontish, close

big, in, still, mirror, dinner, city, wishes This is an interesting index system Bill-sticking is forbidden in this city

e

Front, mid

bed, spell, feather, fled, treasure, many Fetch ten eggs from the red hen’s nest Mend the fence when the weather’s better

æ

Front, mid

bad, man, shall, fatter, hammer, had, valley Harry was standing by the back taxi rank Grab that ladder and hang up the banners



Open, central

bud, result, 1ove, gum, other, onion, rubber The sunflowers were covered in ugly bugs Don’t rush under the hut unless you hum

ɒ

Back open, rounded

bog, sob, shone, hol1y, profit, knowledge He’s got a lot of copies of the song The hot dog wandered along the docks

υ

Back close, rounded

good, pull, wood, bullring, would, shouldn’t He took the cushion and shook it Have a good look at this cookery book

ə

Central mid

butter, father, cupboard, sugar, a heater, The best of the players was injured Her hands were as cold as a block of ice

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Table 14.1 Continued

Symbol

Place in RP

Words and sentences

Diphthongs ai

Front-open to frontish-closer

buy, rise, climb, smile, life, light, cider The ice was white and high for miles The bright light was shining in my eyes

ei

Front-mid to frontish-closer

day, plate, spade, game, faint, rate, claim Take the name of the place where we stayed Jane can explain this strange mistake

ɔi

Back-mid to front-closer

boy, annoyed, coin, boil, oyster, enjoyable The toy employee was boisterous The oil had spoilt the embroidery

aυ

Front-open to backish-close

bough, louder, house, owl, astound, mouthed Sounds are pronounced with a round mouth Brown owls were all round the grounds

əυ

Central to backish-closer, becoming rounder

no, soul, bone, stolen, ocean, hope, odour You know they don’t own their own home Joe groaned, but showed off his own oboe

iə

Frontish-closeish to central

dear, appear, fierce, curious, exterior We’ll interfere with the gears, my dear These hats here appear to be superior

εə

Front mid to central

bare, chair, careful, repair, ary, scarce She can barely spare the money for her fare Do we dare to care for that shared affair?

υə

Backish closeish to central (tends to be a single vowel in younger speakers

tour, pure, mature, jewel, steward, manure Stuart used his influence in the duet He secured the tour of the pure jewels

A tool such as this provides practice material for acting students learning RP. It also provides a way for them to note how they make these vowels in their own accent, or to note the vowels of a regional accent needed for a show. The acquisition of accents can present significant challenges to actors and is a specialist part of voice teaching. Films and larger shows will employ an experienced dialect coach, but other actors will often need to work alone, and their auditory skills vary greatly. A recent excellent aid to this task is the series of CDs that offer accent recordings and practical exercises (Dyer and Strong 2007).

Box 14.2 Turkish lawyer (Zorlu): vowel analysis for practical work Long vowels (two dots after symbol signify long vowel) i: – accurate enough : – too back and short, with frequent intrusive /r/ (e.g. heard is pronounced /h:rd/) a: – accurate enough, but frequent intrusive /r/ ɔ: – needs to be more open, and /r/ issue again u: – accurate enough

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Short vowels i – fine e – fine æ – sounds like /e/ – needs to open up – fine, but tends to devoice final /d/ when following this vowel ɒ – fine υ – fine ə – fine Diphthongs ai – fine ei – fine ɔi – fine aυ – too long second element əυ – too close on second element iə – fine – but intrusive /r/ issue εə – fine – but /r/ issue υə – fine – but /r/ issue

Pace Some of us speak fast and some slowly. People often feel that their speed of talking relates to the speed that they think, but it is more clearly linked to our essential rhythm of being – fast speakers tend to move quickly and vice versa. Most take the speed at which they speak for granted, and consider it to be normal. In group voice work a speaker encouraged to speak at a slightly slower speed than usual is often amazed at listeners’ approval. He feels that he is speaking at a snail’s pace, whereas they feel that he is giving them time to take in what he is saying. Without an awareness of habitual speech pace and an exploration of pace options, the instruction to ‘slow down’ is generally ineffective, even though it may be very important in a room with a large, echoing acoustic. As it is so linked to their rhythm of life, it is hard for speakers to change their speed in ordinary conversation, and often not necessary if they can learn to allow pauses, so that listeners have time to process the message. Phonetician Mark Huckvale compared Winston Churchill’s original broadcast of his famous ‘Finest Hour’ speech with a reading of the text by broadcaster Melvyn Bragg. He found that, at around 180 words a minute, Bragg’s version was considerably faster (60 seconds as opposed to Churchill’s 100 seconds) and had the focal stresses in the expected places. He writes ‘what was odd about Churchill’s reading was that it was phrased and accented in a very unintuitive way, but maybe this very unpredictability made it more interesting’ (personal communication, 2007). When Huckvale swapped over the timing between Bragg and Churchill for comic effect, he found that ‘Churchill seems to rush through it, and Bragg seems slurred and drunk!’. A fast speaking speed can give a sense of energy and vibrancy, but too fast can be difficult to interpret, exhausting to hear, and convey a sense of tension or insecurity. A slow speed will often suggest authority and power – with the sense that ‘it does not matter if I keep

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you waiting while I speak’ – but too much will come across as ponderous and heavy. The essence of effective speaking is contrast, and varying the speed is an important and not often recognised skill in vocal variety.

Pause Pauses are vital in instrumental music, and vital in the music of speech. They allow a speaker to let breath drop in, to look at listener or audience, to gather thoughts and to hold a moment of silent power before continuing. They provide markers that something important is to follow and enable listeners to process and consider what has just been said. Silent moments suggest that the speaker has the authority and confidence to allow space between her words – she can hold her peace as well as her words. The use of pause in the theatre can be very powerful. Writing about Peter Brook’s ‘Measure for Measure’, Kustow (2005) quotes critic Harold Hobson who wrote of the ‘enormous pause (during which at the first performance the audience dared scarcely breathe) that with unbelievable bravado he places before Isabella’s plea for Angelo’s pardon’, whereas the critic Ken Tynan described the 35 seconds as ‘a long prickly moment of doubt which had every heart in the theatre thudding’. In a BBC radio interview after the announcement of his Nobel Prize for Literature, Harold Pinter discussed his own reputation for the varied use of pause in his plays, and laughingly said that his wife had said ‘the pause is the curse of Pinter’. Actor Pete Postlethwaite described how the cast of one Pinter play formed the theory that different pauses were signalled differently in the text. If the word pause appeared, it meant that there was just a break for a few moments before something continued. If the word silence was written, it suggests that something will be changed when the action begins again, whereas a few dots . . . show that the character is struggling for words. In public speaking the frequency and length of pauses can certainly be over-done, but most public speakers use too few, and do not hold the silence for long enough. They often need to practically explore the length of a potential pause. Medrado et al (2005) quote research that found that the minimum duration required for a silence period in speech to be considered to be a pause is a quarter of a second, but it can be significantly longer. If you notice that a speaker has a surprisingly large number of long pauses, and appears to struggle to move onto the next word, there may be a significant fluency problem. Group participants are often surprised by how long they can acceptably hold an anticipatory silence between two sentences in the simple pause exercise in Chapter 25. As in many judgements of their own oral delivery skills, speakers may not know their potential or what works best, and group feedback can be very valuable. Pauses may be silent or filled with little sounds. Writer Tony Kushner (2003) writes amusingly on the relevance of the different lengths of one frequently used filler: ‘Um’ is a swallowing sound. The speaker makes it, when, aware or not, he or she has words to say, a response to make, which must not be spoken, which must be gulped down instead. ‘Umm’ on the other hand might start out as simple ingestion – the insult is being incorporated. But that rolling ‘mm’ suggests other things: contemplation – the remark is being weighed; degustation – the insult is being savoured. It might, as it slips from the ululatory to the guttural, be the beginning of a growl – ‘Ummmmm. Watch it!’ (Reproduced with permission of Tony Kushner.)

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Carroll (2000) says that ‘studies indicate that on average people use 200 filler words a day’. She describes how the way that these are spoken can have a negative or positive effect on voice. If spoken abruptly, they can reinforce tension patterns, but if the speaker learns to resonate and elongate them ‘with a slight melodic pattern’, they can provide regular opportunities for a healthy ‘reboot’ of the vocal mechanism – ‘well-directed vocal massage’.

Fluency Most of us sometimes hesitate, repeat and use those filler sounds as we think. A slight degree of such non-fluency is normal and acceptable in ordinary conversation, and indeed the toofluent actor in a naturalistic radio or TV drama may not sound believable as his character. This can also be true in some sorts of public speaking; a politician’s speech was once described as ‘just too slick and non-stop to be true’. If, however, fluency interruptions are too noticeable, they are likely to have a negative effect on those compelled to listen. Some speakers dread the non-fluency that happens when they are nervous, whereas others are unaware of their distracting interruptions. Voice teachers need to be aware that a fluency problem may be an actual stammer (or stutter), for which treatment is highly specialised. A stammer may have repetitions of sounds or syllables (e.g. I c-c-c-c-can’t say), prolongations (Please lllllllllllet me sssssstay) or blocks – where part of the speaker’s speech musculature seems to ‘lock’ so a speech sound cannot emerge for a few seconds or longer. If a practitioner suspects that fluency problems may be a stammer, he should always refer the person for specialist SLT opinion and help. It can be a very distressing and challenging condition for speakers, and can also have strong effects on listeners. Guntupalli et al (2007) found that listeners had higher heart rates and felt more uncomfortable when they watched videos of severely non-fluent speakers as opposed to film of fluent speech. The authors speculated that unexpected speech disruptions can affect a listener’s autonomic nervous system, and send a fear message to the rest of the body – another example of the way that a speaker’s voice patterns can affect the psyche-soma of those who hear him.

Rhythm Thurburn (1939) wrote ‘rhythm is the most important factor in all aesthetic work and it is also the most elusive and difficult to define. It is the universal factor, which welds into coherence what would otherwise be a series of disconnected episodes’. Moses (1954) described normal rhythm as ‘a mixture of an individual’s biological rhythm, learned language and the meaning inherent in the utterance’. Using the analogy of music, we can consider the rhythm of speech as the essential beat. It is created by a mix of factors, and hence comes at the end of the Voice Skills programme: • Loudness emphasis such as word stress and sentence stress • Pace

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Pause The length of words and sentences The syllabic structure of words The flow or fluency of the phrases and sentences Pitch changes.

The rhythm of a word, phrase, poem, speech, play, book or language conveys its particular energy. Reading prose and poetry aloud gives access to intellectual, auditory and visceral experience of rhythms different to our own, and these then become more available to us. Even in silent reading, we can sense the internal rhythm in the word and sentence weights of different novelists, and in reading aloud we find the sound and feeling of those rhythms. A rhythm exercise in Chapter 25 describes a movement exercise where clients walk the word and sentence patterns of five paragraphs from different novelists. The rhythms of speech help us to learn things by memory; we feel the text in our bodies and it is no coincidence that we talk about learning ‘by heart’ rather than learning ‘by head’. Story, image and rhythm are three great foundation stones of oral traditions, and have a powerful effect on us. And then he recalls, as he often does, lying in his boyhood bed and hearing through the plaster the sound of his parents talking in the next room. Their night noises, their bed talk. The woody rasp as they cleared their throats or blew their noses. Sometimes it went on and on. The words were inaudible, a low buzzing reverberative music whose content, to their son Larry at least, was unguessable. First his mother, then his father, back and forth like a kind of weaving. There would be a pause and then the murmurous resonance resumed. He would fall asleep finally to the rhythm of those strange voices: Stu and Dot Wheeler, his silent parents, coming awake in the sound waves of their own muffled words, made graceful by what they chose to say in the long darkness. From Larry’s Party Carol Shields (1997)

Chapter 15

Voices and emotions

Part 4 has looked at some core foundations of each of the voice skills, but it would be incomplete without some discussion of the emotional aspects of voice and voice work. The first section of this chapter looks at some of the links between emotions and voices, with illustrations drawn from both clinical and literary fields, whereas the second section describes the way that voice work can change an emotional state. The final section outlines the kind of action that can be taken when a voice practitioner feels that a client’s emotional distress or disturbance suggests that he needs some special management or extra professional support.

The links between voice and emotion The factors that shape voices Many factors affect our general emotions: our childhoods, family relationships, friendships and school success or failure; our social life, socioeconomic group, working life and housing; and our personal relationships, sense of self-worth and creative outlets. Our emotional reactions shape our bodies and our voices. The work of Jungian analyst Marion Woodman (1985) has long focused on the way that the body holds and expresses emotions, and how practical body, voice and artwork can effect transformation in feelings. The ever-developing field of neuroscience offers theories and research findings that support this idea that emotions are physical body states; our fear, sadness, anger or happiness is not just in our head but in our bodies. Indeed Damasio (1999) and others have shown that the body often emotionally responds before the brain registers what is felt. Something happens – our bodies respond in posture, tension, breathing patterns, facial expression and vocal aspects – and we know that we feel an emotion. These bodily reactions are generally universal and voice is part of that musical ‘metacommunication’ that can transcend linguistic, cultural and emotional barriers. Kustow (2005) tells a story of director Peter Brook’s theatre company in Africa. ‘The Peulhs, a gorgeously tricked-out group, face-painted and bejewelled, who disdained all the musical

Voice Work: Art and Science in Changing Voices. Christina Shewell © 2009 Christina Shewell. ISBN: 978-0-470-01992-4

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offerings from Brook’s actors until they finally decided to join them in a long sustained “ah” sound. It was as if the Peulh were pulling the sound from them. They pointed to the sky. . . . Somehow the sound makes itself.’ One can only speculate on the harmony that might result if all international meetings could start with a group humming session. Sundberg (1987) describes a research study in which actors read one sentence with different emotional tones; these included neutral, love, joy, solemnity, comedy, irony, sorrow and fear. Different groups, who did not know the language of the words, identified the emotions. Sundberg writes that ‘each emotion and attitude has its own typical pattern of movement which exerts an influence over the behaviour of the entire body, including the voice organs’. These may be long-term habitual patterns or temporary sculpting by transitory emotions. Strong feelings can precipitate a ‘psychogenic’ voice disorder, and this is described in Chapter 27. The word ‘personality’ has come from the Latin ‘persona’, which was the mouthpiece of a mask used by actors. ‘Per sona’ means ‘through sound’, an apt description for how our inner world communicates to others. Sometimes, however, the speaker outgrows a vocal mask.

Voice story: Helen Helen was a 20-year-old biology student. ‘I just don’t like my spoken voice,’ she said, ‘it sounds so thin and prissy, but when I sing there’s so much more woomph to it and I feel much more myself.’ Helen’s spoken voice was breathy and slightly high pitched, with a tight pattern of jaw closure, and it lacked lower resonant quality. In her choir singing, she used an open mouth, deep breath and strong bodily energy, and revelled in the deeper resonant sound of her full voice. We discussed why her sense of personal power seemed only to belong to her singing, touching on both technical and emotional aspects. Helen told me that her parents had separated when she was 3 and, until she was 16, she lived alternate months in each of their nearby houses. She knew that they both loved and wanted her, so throughout those years she had been uncomplaining about the situation, even though she longed to end her split life, and the split that she felt in their continuing mutual bitterness. Helen described herself as always trying to make things right, and that she recognised that she had played the part of the charming child. It seemed possible that she had kept her feelings ‘battened down’ below conscious level, cut off from the body feeling, and placating and supporting her parents with her behaviour and her voice. Since leaving home for college, Helen said that she frequently felt anger that her parents had not seen how hard it had been for her. She followed my tentative suggestion that she might consider talking with the student counsellor, and meanwhile, over several sessions, we worked practically to open up her body, breath, channel and resonance aspects. She also went to several group voice workshops with an excellent exploratory voice guide. Here her voice was able to whoop, chant, shriek and soar in ways that were far from generally socially acceptable. With attention to both feelings and body, she was able to release and live into a much freer and fuller spoken voice and said that it felt ‘much more connected to who I really am’.

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Other voice changes come and go. We ring a friend and he answers with a one-word ‘hello’, but from those two syllables we know that something is wrong. We have not consciously analysed his voice, but its unusual depth, slight hoarseness, monotone quality and lack of his usual energy all tell us that all is not well, and we feel his distress. Our voices can get ‘husky with passion’, ‘choked with emotion’, ‘shrill with fear’, ‘tremulous with guilt’, ‘deep with longing’, ‘high with excitement’, or gain nasal resonance as we moan and chest resonance as we seduce. We adapt our voices to chat, cajole, enquire, request, accuse, seduce, humour, complain, caress, energise or calm our listeners, and we usually change them without conscious control. After a slightly ‘out-of-the-ordinary’ incident, it can be interesting to consciously analyse what your own voice has done.

Personal story I lost the key to my locker after a swim at the local pool, and was in a hurry to dress, as I had to get to a meeting. I went to ask help from the caretaker, a man whom I instantly assessed as being older than me. ‘I have a bit of an emergency,’ I said, and explained the problem. Only afterwards, hurrying away, did I recognise that my voice had risen in both pitch and resonant quality, and the breathiness of my phonation had slightly increased. I had felt like a rather incompetent and helpless schoolchild and had sought support from a male authority figure; the situation had unconsciously connected me to a somatic memory of being a schoolchild asking for help from the school janitor. My voice communicated insecurity and an inward looking focus – what Rodenburg (2007) describes as being in ‘First Circle’ energy.

Voices are doubly psychosomatic phenomena. As well as expressing a speaker’s emotions, the sound of a voice can have a strong psychosomatic effect on listeners, touching both their physical sensations and their emotions. We are perhaps most aware of this in our reactions to the singing voice, where emotions can be intensely distilled in the marriage of music and voice. Helen Bamber founded the Medical Foundation for the Care of Victims of Torture and is now the director of the Helen Bamber Foundation. This provides medical consultation, therapeutic care, human rights advocacy and practical support for survivors of torture, domestic violence, trafficking, honour killings, genocide and rape. She talked (personal communication, 2008) of how she dealt with hearing the appalling stories that people told her, and said that she had sometimes found it unbearably painful to listen to the singing in the Medical Foundation’s weekly music group. ‘We had a sad desolate woman from Iran who would sit and tap out a tune. One day she lifted her head and sang, and I had to leave the room. There’s something about the human voice; understanding the capacity people have for creativity and what has been denied them. Perhaps it’s about what people might be if left alone.’ Bob Dylan (2004) describes a different sensory–emotional reaction to singing: ‘Brown Sugar . . . had a thick, slow, dreamy, oozing molasses voice – she sounded big as a buffalo. . . . I wondered if she knew her voice had drawn me in, filled me with peace and serenity and would upend all my frustration.’

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As described at the beginning of the book, listeners often have strong feelings about which voices they like and dislike. Negative voice qualities can even cause financial loss, as seen in the ingeniously designed study of Ambady et al (2002). This compared listener judgements of the vocal tones of surgeons who had been sued for professional malpractice with those who had not. Twelve judges listened to very brief clips from 114 conversations between patients and surgeons, and rated each clip on a 7-point scale of emotional qualities, such as warm, interested, professional, competent and genuine. The voices judged as being at the negative end of the scales were highly correlated with the surgeons who had previous malpractice claims against them. The authors conclude that ‘the current findings are novel in that they show that speech and voice tone alone judged from mere 40-second slices of speech, can distinguish between claims and no claims interaction’.

Voice parameters: correlations with feelings As long ago as 1954, psychiatrist Paul Moses published a book on what he called ‘the voice of neurosis’, and used a number of vocal parameters from which to ‘interpret’ personality. Although his views were largely based on personal view rather than group research, the book is still interesting reading. The interrelationships of particular core emotions, vocal features and listener judgements are not completely reliable and predictable, but researchers in psychology, psychiatry, linguistics and speech science have found many connections and general tendencies. In his comprehensive review of the vocal communication of emotion, Klaus Scherer (2003) talks of the ‘lively research activity that has sprung up in this domain’, and describes how speech scientists have increasingly been able to identify important relationships between acoustic speech parameters and speaker attitudes and emotions. The field is wide, but I will describe some examples as an illustration. The voice in anger is usually almost half an octave above neutral pitch speech level, with an extensive pitch range and the forceful emphasis of some syllables using loudness and pitch. Pronunciation of speech sounds tends to be very precise, with firm contacts of the different articulators. The voice of someone in great fear can vary, according to the nature and length of the perceived threat. It may have a generally lower pitch level than anger, but in times of immediate or acute anxiety there may be sudden peaks of high pitch or high loudness; these latter features have been found in voice samples from air traffic controllers communicating about an impending air disaster. In sorrow the voice has a narrow pitch range, with a tendency to a falling pitch line; articulation of long vowels and consonants is slow, and there are usually frequent pauses, whereas the phonation quality may have tremor or increased roughness or breathiness. No matter what is happening in her personal life, a singer or actor has to learn how to vocally hide her own emotions, in order to find, feel and express those of the song, character or text. Voice practitioners can help other professional voice users to become aware of how voice may be affected by fear or any other emotion, and to learn how this can be controlled by practical work. We use the eight voice skills headings to look at how voice may be affected by emotions.

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Body and breath When we feel good, we tend to have freer bodies and voices and we are more likely to breathe more deeply. In emotions such as anger, anxiety, grief or bitterness, we may try to block the feeling by holding our bodies and breath rigid. What feels like a stone of disappointment and resentment seems to be lodged inside her, just above her diaphragm; at moments of anxiety or anger she presses on that place with both beringed foists, as if to push deeper into herself this indigestible thing she is condemned to carry about with her. It feels as hard as the diamonds and sapphires that hang from her neck or earlobes but much larger than any of them. (Jacobson 2005)

Breath affects emotions and emotions affect breath. In fear we often take quick shallow breaths through a tight throat and, if we deliberately breathe quickly in and out, we are likely to create a feeling of urgency and stress in our bodies. Such a pattern can become the hyperventilation of panic breathing. Conversely, if we are afraid, and we repeatedly blow out a long breath and then breathe slowly deep into our bodies, we may feel calmer. ‘It has long been known that slow rhythmic diaphragmatic breathing can soothe our inner storms and make us feel calm and composed’ (Timmons and Ley 1994). Listeners may unconsciously adjust their own breathing in conversations to that of the other speaker. Some speakers deliberately match their breathing to another’s as part of ‘mirroring’ techniques designed to express empathy and support. In a group context, a rapt theatre audience may breathe with the emotions of a character on stage. Professor of drama Rocco Dal Vera (2001) describes how actors can deliberately take on the particular breath patterns of core emotions (happiness, sadness, tenderness, anger, fear and eroticism) to help access characters’ feelings and behaviour.

Channel Emotions may affect voice at any point along the channel of sound; we may be ‘all choked up’, ‘granite jawed with stress’ or keep a ‘stiff upper lip’. Research into the appearance of the vocal tract in different emotions provides pictorially apt metaphors. Sundberg (1987) quotes I. Fonagy and K. Magdics who found that the participants in their study had a wide space between their true and false vocal folds if they were tenderly whispering, but this was narrow and tight when whispering spitefully – the open relaxation of love versus the tense edginess of malicious gossip. They described how, in anger, the tongue was like an ‘aggressive arrow’ in its precision of consonant articulation.

Phonation An increased breathy phonation may occur when there is a nervous lack of commitment or confidence, as if the vocal folds can meet in only a ‘tentative’ way. Yet the voice of seduction is also generally associated with breathiness, as if conveying the subliminal message that ‘I am open to you’. The tension of anger tightens and lengthens vocal fold closure, resulting in a harder sounding voice, whereas in tenderness the folds are likely to be lax, with a longer open phase.

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Some changes in phonation quality may be important in the performing voice. It is interesting to note that if we turn on the radio we often know whether an actor or ‘real person’ is speaking. This may be due to the phonation quality variation rather then the adequacy of acting skills. Some actors’ voices keep phonation almost too smooth, relying on changes in pitch, channel and loudness to express the emotion of the character. It does not sound quite natural, because ordinary speakers often have considerable variation in the breathiness, creak, roughness and tension of their vocal fold closure in the fast flow of their conversational speech. Although classical and opera voices need to avoid those phonation quality features, they are vital in most pop, jazz, rock and musical theatre styles, where they often carry a strong emotional message.

Resonance A balance of head, oral and chest resonant qualities will contribute respectively to the carrying power, precision and warmth of a voice. An imbalance may strongly affect listeners. If we clench in our throat and soft palate we may send too many vibrations up through the nose, creating an excess nasal resonant quality that may sound thin and whining. This tends to be associated with the complaining voice. If we have too forward an oral resonance with little of the warmth of chest resonant quality or the ring of head resonance, the voice may sound nervous or ‘lacking any edge’ – what my own voice teacher called the ‘Miss Mouse voice’. On the other hand, too much deliberate chest resonance, with lowered larynx and breathy phonation, can sound over-contrived and false. We respond strongly to the resonant qualities of a voice, and research has shown that even animals may assess each other from the sound of their resonant qualities. Male red deer modulate the resonance of their calls during rutting, and can tell the size of a rival by his sound, adjusting the sound of their roars in response to what they hear.

Pitch A too high centre pitch can convey nervousness or an immaturity, whereas a pitch that is too low may suggest an artificial attempt to sound authoritative.

Voice story: Mike Tyson Boxer Mike Tyson is said to have developed his fighting energy as a child on the streets of Brooklyn, when he learnt to physically attack those who taunted him about his unusually high-pitched girlish voice.

Pitch range is also relevant. The narrow pitch range can convey a monotony of both vocal music and energy, and when very restricted is associated with depression. A repeatedly falling line can create a soothing effect, quite appropriate for a tense situation but may lull after-dinner listeners into sleep. The public speaker needs a wide enough pitch range to

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suggest energy and interest, but this should not be so wide that it suggests mania or the kind of tone used with children. Phonetician Evelyn Abberton (personal communication, 2006) confirms that the ‘child-directed voice’ tends to have a high average pitch with an extended top range and a tendency to a rising pitch line. Even in tonal languages such as Cantonese, where word meanings can depend on a particular rising or falling tone, she says that the rising tones rise even higher, so making the perceptual task of interpreting meaning easier for babies. The speech of adults to young children usually has energetic articulation of consonants, emphasised words with a slower speed and more pauses than adult-to-adult communication. These findings are a reminder of why listeners can feel patronised if an adult uses too many of these patterns in communication. So Rebecca changed to her grandma voice and said, ‘Oh, what fun! What did you see? Tell me all about it!’ She loved these children, every last one of them. They had added more to her life than she could have imagined. But sometimes it was very tiring to have to speak in her grandma voice. (Tyler 2001)

Loudness An over-loud voice may suggest aggression, nervousness or lack of control, whereas an over-quiet voice tends to convey timidity. But similar to all suggested voice–emotion correlations, this has to be taken in the whole context. Although the very quiet voice of a ‘low status’ speaker can limit his ability to come across as confident and competent, the soft tones of an authority figure can be intimidating, because it can convey the message that his power is such that he has no need to raise his voice. As children we learn to modify our voices in response to social pressures but, as adults, a wide use of pitch and loudness can connect a speaker or singer to a sense of the ‘Big Me’ – confident, energised, committed and grounded in the body. She stood up. At some point she had made the mistake of taking off her shoes, and in a room full of men this small woman seemed especially small. . . . But when she put her shoulders back and raised her head it was as if she was willing herself to grow, as if from years of appearing far away on a stage she had learned how to project not just her voice but her entire person, and the rage that was in her lifted her up until she seemed to tower over them. (Patchett 2000)

The loud vocal sound of a group can be very powerful. For centuries the war cry has been a part of advancing armies, and even now these qualities can be heard in the massed sound of great crowds at football or baseball matches. Strong voice accompanies the body, tongue and eye movements used in the great Maori Haka to express challenge, welcome, exultation, defiance or contempt.

Articulation Regardless of regional accent, the way that speech sounds are pronounced can convey a message to listeners. Precise consonant contacts suggest clarity, confidence and accuracy, whereas indistinct pronunciation is likely to give the opposite impression. Similar to loudness, the effects of pace and pause are to some extent speaker dependent. A very fast pace

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may convey a brilliant sparkling mind in one speaker, but suggest insecurity in another. Generally, if you have power, you know that people will wait for your words and your pauses, so you can take your time. Too many pauses may suggest hesitancy and insecurity, but too few imply that we dare not allow silence. We discourage public speakers from using filler sounds such as ‘um’ and ‘ur’, but, used as reinforcers, they sometimes convey a positive message. She found the ‘attuning’ sounds of the therapists – the ums, aahs, grunts and exhalations and exhalations – immensely comforting. ‘They give me a sense that somehow you know how I feel, however much you appear distant, rejecting or uninterested (all words she had used about her parents) in your verbal comments.’ (Holmes 1993)

The disembodied voice Our habitual voice may not be that which we use when most connected to a comfortable sense of our deepest self. The concept that everyone has one ‘true voice’ is dubious in that a person’s individual ‘vocal music’ may greatly vary, whereas terms such as ‘free’ or ‘natural’ voice allow for variety. The image of the ‘disembodied’ or ‘disconnected voice’ refers to the voice that gives the impression of being focused in one small place in the body, as if head or throat is ‘cut off’ from the rest of the body. In these cases the sound usually strikes us as different in quality from what we would expect in a person of that size, age, character or behaviour; it gives the feeling that something is hidden or unaccessed. Helen’s voice, described earlier, is an example of such a voice. Body work will be the first step in these cases, because, as Roth (1999) describes, we can ‘live outside ourselves – in our heads, our memories, our longings – absentee landlords of our own estate’. The Canadian Jungian analyst and writer, Marion Woodman (1985) writes of her analysands: ‘while their egos may be approached through confrontation, challenge or humour, their bodies cannot respond . . . the body, like the child, tells the truth, and it tells it through movement or lack of movement.’ Every now and again I meet someone whose speaking voice appears to be placed artificially, to come not from the centre of the person, but from an unnatural register. I am thinking especially of women with high strained voices. I know nothing about voice placement in a technical sense, but I have longed to say ‘for God’s sake, get down to earth and speak in your own voice!’ (Sarton 1985).

The disconnected voice may also be too low.

Client story: Ben Ben was a popular music broadcaster on a local radio station, renowned for his deep husky voice and wide intonation range. It was classically ‘sexy’ but even on the radio it sounded like an act. When he came to see me with a muscle tension voice problem, I was taken aback to find that his conversational voice had exactly the same exaggerated qualities. I asked whether he had always had such a distinctive voice, and he told me that, in his late teens, he had practised for hours to acquire his sound by deliberately

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imitating a successful 1970s’ DJ. His voice was not his own, and the tension of maintaining that pretence was causing problems. Voice work focused on freeing up body and vocal tract but had limited success, because Ben was reluctant to abandon either his artificially lowered larynx position or his voice mask.

Sometimes of course it is appropriate that the voice hides our feelings. Actors, musical theatre singers and impressionists learn to take on the voice of another and to express the emotion of that character in such a way that it feels and sounds completely believable. Non-performers may also sometimes need to ‘play their voices’ and this may be part of protecting our private self. An interesting example of a well-known speaker is given by journalist Graham Turner (2002): Those who have seen a good deal of the Queen sense that here is another very different woman concealed behind the normally impregnable façade of self-control. ‘In private’ said Douglas Hurd ‘she has a deep, rather masculine laugh, a foxhunting sort of laugh. Her voice goes right down from that artificial high level to something rather earthy. That, I think, is the real Queen. It suggests to me that there is somebody else down below.’

Voice work to change feelings Changing the voice, changing the mood We may not be able to change the situation that is affecting our stress or contentment, but we do have some control over how our body deals with that emotion; if we recognise its reaction and do something different, we can feel different. Neuroscience findings suggest that emotions are physical states, and changing a physical behaviour can change an emotion – the basis of Dal Vera’s (2001) work (cited above) on breathing. He gives an amusing example; if you are angry and stand on your head, you are unlikely to continue to feel angry because your body doesn’t know how to do those two things at the same time (Dal Vera 2007). If we feel powerless, we may get in touch with our own sense of physical power by arm waving, jumping up and down, or calling ‘yes’ a number of times with increasing loudness. If we feel tension, fear or misery, but stand and stretch out our arms to the sky, let a deep breath come in and release a loud open ‘aah’, we may feel better. The worries remain, but the muscles release a little, and emotionally we may feel a sense of being able to expand, open up to life and connect to some sort of power. Even if we feel self-conscious and silly, something changes. Voicing is a physical behaviour and it can change emotions. We yell our frustration to the cat, and feel a sense of relief. People may experience an increase in energy after ‘a good sing’ at a church service. Roth (1999) writes ‘feelings get stuck in the throat. We get choked up with sadness, constricted with fear. But if we could wholeheartedly wail our grief as mourning Spanish women do, or shout our joy like celebrating Zulus, we’d begin to feel the pulse of pure emotion once more’. Margaret Atwood’s lead character in Lady Oracle (1982) describes the release that singing can give. ‘For a while I wanted to be an opera

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singer. . . . It always appealed to me; to be able to stand up there in front of everyone and shriek as loud as you could, about hatred and love and rage and despair, scream at the top of your lungs and have it come out as music. That would be something.’ Of course such vocal release needs to be done in an appropriate context. Although it may be a release for the person giving voice, loud unexpected voicing can startle listeners and may even convey an impression of emotional instability. The career of American politician Howard Dean was profoundly damaged in January 2004 when he let out an uncontrolled yell of anguish at the news that he had failed in his attempt to be elected as democratic candidate. The story of that strange sound was picked up and played by every major news agency, with a strong sense that, if your president has his finger potentially on a button of mass destruction, you do not want someone who cannot control his own vocal explosion. The voice of the thwarted baby pulsates with energy, but, as we grow more socially adapted, we have to learn to hide that ‘sounded fury’, even when we long to let it stream out. Poet C.K. Williams describes it well: Tantrum A child’s cry out in the street, not of pain or fear, rather one of those vividly inarticulate yet perfectly expressive trumpet thumps of indignation: something wished for has been denied, something wanted now delayed. So useful it would be to carry that preemptive howl always with you; all the functions it performs, its equivalents in words are so unwieldy, take up so much emotive time, entail such muffling, qualifying, attenuation. And in our cries out to the cosmos, our exasperation with imperfection, our theodices, betrayed ideals: to keep that rocky core of rage within one’s rage with which to blame, confront, accuse, bewail all that needs retaliation for our absurdly thwarted wants. (Reproduced with permission of Bloodaxe Books from C.K. Williams, Collected Poems (2006). Available at: www.bloodaxebooks.com)

The appropriate release of feelings in words or sound can be part of managing anger. If you shout at someone, your voice is a weapon. If you feel the anger, but yell out its sound and words when you are alone, it hurts no one, and offers the chance for a change of energy.

Voice story: singing your anger The sleep of one client was frequently disturbed by noise from neighbours, and this made her stressed and angry. Reasonable complaint had so far achieved nothing, but she did not yet want a confrontation. She described how sometimes, as she did housework, she set the stories of the latest disturbance and her feelings to ‘shrieking sung sound’. ‘I’ve created wonderfully furious arias about their bloody dogs,’ she said with satisfaction, ‘and it really helps loosen me up.’

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Work with voice and with voice in great texts can be very valuable to those who are denied a voice in society. As well as her work with actors throughout the world, voice teacher Cicely Berry has worked extensively with prisoners and in Seoul, New York and the slums of Rio de Janeiro. She says ‘it can be dangerous but they love working on these things. When you cannot speak your anger, what is there left but violence?’. Her work is extensively described in the DVD ‘When words prevail’, listed in the website section in Appendix I.

Free voicing In ‘free voicing’ a person warms up his body and breath in movement and then allows himself to make any vocal sound that ‘feels right’. He starts on a simple vowel sound and lets this develop into a voice improvisation with a spontaneous variety of intoned vowels, syllables, pitches, resonances and phonation qualities. It can be done alone or in a group, when wonderful choral harmonies and dissonances are woven into a creative cacophony. It can lead to deep emotional release; performance artist Cynthia Whelan (personal communication, 2005) describes such an experience: ‘I felt as if I had an endless ribbon unravelling from my mouth. It opened my heart.’ Such vocal improvisation is sometimes referred to as ‘sounding’ and ‘toning’. Keyes (1973) wrote: ‘each time I toned, my body felt exhilarated, alive as it had never felt before; a feeling of wholeness and extreme well-being.’ D’Angelo (2000) says that ‘regular conscious voicework will help to lessen and dissipate negative emotions in day-to-day life, if and when they do arise, and will allow the positive emotions to emerge more easily’. The practice of voice movement therapy works with clients’ bodies and voices as a method of therapeutic growth. It originated in the work of Paul Newham (1998), and now functions under the aegis of the International Association for Voice Movement Therapy with its aim as the ‘exploration of the self through vocal expression’. In such sounding, the voice may move into a huge range of sounds, creating extraordinary vocal qualities and rising and falling far beyond conventional singing pitch limits. Alfred Wolfsohn (see Pikes 1999) worked with this vocal extension for artistic and psychological transformation, and it was developed by his pupil Roy Hart and the theatre that he founded.

Personal story: singing black Twenty years ago, after a period of emotional stress and loss, I changed both my personal and professional life and started training as a voice teacher in London. During the course, I went on a summer school at the Roy Hart Theatre in France. It was a time of intense physical and voice work – individual voice sessions with a teacher each morning, and 3hour sessions of group improvisations in the afternoons. It was energising and I finally felt my optimistic self again. On the third day, the teacher, Robert, asked me to sing up

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a scale using a different colour name for each note. I sang up, strongly intoning each word – blue, red, yellow, green, pink – and was pleased with my automatic French as I found heard myself singing ‘noir’. ‘Sing that one in English’ said Robert. I tried – but found that my lips and throat tightened so much that nothing emerged. ‘Try again – sing black – strong and loud’ Robert encouraged. All that came out was a strangled sob. Robert left the piano and rubbed my back. ‘Come on’ he said, ‘just have another go at singing that old friend black.’ I was frozen, hardly able to take breath and all sound felt impossible. Robert kept a warm hand on my back, and asked me to breathe in a sense of ‘blackness’, and to allow my body to be shaped by any feelings that might come. With great skill, he took me through a series of movements and sounds until I could finally sing ‘black’ in a strong open sustained sound. Then he asked me to vocally explore Lady Macbeth’s lines: ‘The raven himself is hoarse That croaks the fatal entrance of Duncan Under my battlements. Come you spirits That tend on mortal thoughts! Unsex me here, And fill me from the crown to the toe top full Of direst cruelty.’

In these lines, I found a voice I had never heard before, full of an energy that was a mixture of grief, anger and power. It was exhilarating and led to a deep sense of transformation. Through the voice work, something had been released and a new vitality had been found.

Voicing as healing As described in Chapter 2, research in the relatively new but ever-expanding field of psychoneuroimmunology shows that our emotions affect our neuropeptides – the chemical messengers of our body – which in turn affect the cellular structure and health of our bodies. We have long known this in the connection between stress and heart disease, but can see it in a simple model of vocal damage. Emotional stress can become muscle tension in the whole body can become muscle misuse in voice production can become a voice problem can become a voice disorder with no damage to the vocal folds can become a voice disorder with damage to the vocal folds.

Some complementary practitioners take this idea further and see particular forms of voicing as part of the field of ‘sound healing’. The use of sound and music for healing can

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be found in many sacred traditions; some writers believe that, even in prehistoric times, shamanic chanting and drumming were used in healing rituals. Goldman (1992) writes: ‘the current field of Sound Healing is enormous in its scope. Sound encompasses virtually all aspects of the auditory phenomenon – from music to nature sounds to electronic sounds to vocal sounds. Practitioners who use sound may likewise use anything that falls within this scope, from classical music to drumming and chanting to electronically synthesized sounds to acoustic instruments. The depth and variety of a Sound Healing may vary extensively, from a client listening to soothing music that calms and relaxes to a client lying on a specially designed bed that projects specific sounds into their body.’ Campbell (1989) describes how ‘through long breaths and with long tones, the body can be massaged from the inside out. Although the sounds may not be beautiful, musical or even expressive, their use will immediately begin to balance physical and mental energy systems’. The idea of healing psyche and cells with sound is generally seen as being on the outer fringes of accepted medical practice, but there is now an increasing literature with some interesting ideas and findings. Maman’s (1997) work is an interesting mix of science and esoteric arts; his book contains photomagnified images of the effect of different sounds on cells. Some photographs show cancer cells becoming disorganised over a period of 9 minutes of voicing ‘an Ionian scale’. With a different focus, the audio-psychophonology work of French otolaryngologist Alfred Tomatis has attracted considerable interest and support in Europe, and is claimed to help deafness, dyslexia, insomnia, epilepsy and emotional disturbance. It is based on the idea that listening to very high harmonics can beneficially develop, recharge and heal the central nervous system and the cortex of the brain. People relearn how to hear the very high harmonics by using the Tomatis ‘Electronic ear’, and to use the high harmonics found in their own voices. Campbell (1989) tells a Tomatis story to illustrate the idea that some voicing ‘recharges’ us. The abbot of a monastery stopped monks chanting for 7 or so hours a day, so that they had more time for useful activities. The monks became more and more tired, but, although they increased their sleep hours, the fatigue continued. The abbot consulted Tomatis who concluded that chanting actually gave energy to the monks; once reinstated, the monks recovered their vitality. Particular sounds are part of the spells and incantations used by many cultures to ‘magic’ something to happen. Healing rituals are one example, as is an Aboriginal belief that it is possible to make someone love you by getting a piece of his hair and singing them towards you. Special voicing practices have always been a part of religious observations. Chanting the great OM of Hinduism and Buddhism, Christian Gregorian plainsong, Sufi chanting, Islamic chanting, Kabbalistic recitation, Tibetan overtoning, all are ways to transcend the limits of ego to connect to the energies of the Divine. One example comes from the publication of a recent Hinduism periodical, where the author quotes the Indian saint Sri Anandamayi Ma: ‘sound used to rise up from my navel. I felt that sounds touched every part of my body and then worship would take place in every pore of my body. The sound would rise into my head and transform itself there into the mantra OM’ (Umananda 2008). Although many of these practices belong to the secret sacred traditions, some exploratory voice guides offer aspects of these in their own work. Even in so-called rational society, some people recount anecdotes about the mystery of voice. One friend tells a story about the mother–child bond when her daughter was born. ‘She was a few hours old and I was going for a shower, and I heard her crying and I knew

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it was her, because it was her voice in me. Her voice was still my voice. But the next day that feeling had gone and I couldn’t identify her voice any longer.’

Working with emotions Whether we are working as voice teacher, singing teacher or speech and language therapist, our clients will sometimes feel and show strong emotions. The atmosphere of trust and ‘encouraged voicing’ that develops within an individual session enables some people to release deeper feelings – about their voices and indeed about their lives. Even in an apparently calm technical class most voice teachers have had the experience of suddenly noticing that a student is weeping in the corner of the room. For the inexperienced group leader it can be worrying but sensitive management can usually ‘contain’ the feeling. We can show that participant that we are aware of his distress by moving over to stand beside him, perhaps gently placing a hand on his shoulder or back, while he deals with the feelings. Sometimes a fellow group member needs to sit with the person, or even occasionally take him outside for a comforting chat and ubiquitous cup of tea. Few voice practitioners are fully trained counsellors or psychotherapists, and nor do we need to be, but we do need to deal in the best possible way with what comes up. In individual work we may find ourselves hearing some very painful or disturbing stories, and the work of all voice practitioners is enhanced and made safer by three factors: 1. The use of specific listening skills 2. A recognition that some clients may need trained professional help, and knowledge of how a client might set this up 3. The awareness that sometimes voice work itself can be a way of creatively working with emotions (described above).

Specific listening skills The use of specific skills in encouraging a person to talk and to feel deeply heard and supported belongs to what might broadly be called counselling skills. To use these techniques is not to become a counsellor, anymore than the use of cooking skills makes someone a chef. Counselling skills are different to the instinctive reactions of friendship; they generally involve a particular focus on the other person and specific competencies in awareness and ways of relating. These are designed to support another person in finding and using her personal strengths to cope more effectively with her life by making appropriate decisions or taking relevant action, or by inner change and growth. Many professionals, including the police, nurses, doctors and business managers, are now trained in basic counselling skills. These enhance communication by improving the ability to listen, to stay authentic and real, to adapt to an individual’s background and needs, and to recognise and respect boundaries. They are part of ‘emotional intelligence’ or ‘emotional literacy’. Orbach (1999) describes this as ‘being able to recognise what you are feeling so that it doesn’t interfere with thinking. It becomes another dimension to draw upon when

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making decisions or encountering situations. Emotional expression, by contrast, can mean being driven by emotions so that it isn’t possible to think’. Few singing and voice teachers train in specific counselling skills but all SLTs need some basic training, because they are often dealing with high levels of distress in client and carers. The SLT professional label allows the option of both practical exercise and deep talking work, and many voice therapy clients are seen who would never agree to go for counselling or psychological therapy. SLTs are encouraged to set up supervision with a fellow professional in their own or in a psychological field, to discuss their work with clients. This is rarely part of the voice or singing teacher worlds, but occasional supervision can offer these teachers a chance for reflection, learning and support, and can form part of the self-care from which these voice practitioners may benefit in their demanding work. All of us need to recognise our limitations, because the amateur psychotherapist is at best embarrassing and at worst potentially dangerous to a client. However, we are often required to listen on three levels: to the voice quality, to the intellectual meaning of the words and to the emotional state of the person. Particular listening techniques are relevant to this third level of ‘psyche awareness’, and outlined below are those that I have found useful in my own voice practice.

Core listening skills 1. Body language awareness: we listen with our eyes as well as our ears, and can pick things up from what the client is doing with posture, facial expression and gesture. A comment may be appropriate to give the client a new sense of what they are feeling, e.g. ‘You clenched your fists when you described how difficult your manager has been, and I could see the tension’; ‘I noticed your hands went to your throat when you told me about your mother’s reaction to the news of your move’; ‘Your whole body stiffened when you said you thought you might never sing again.’ 2. Showing empathy: truly attending to what is said can help us to enter another’s experience, and describing it back to him in client-friendly language, sometimes even mirroring words and body language, helps the speaker know that you are trying to be ‘with them’, e.g. ‘You’re helping me get a picture in my mind of how it must have been. You’re on that stage, the band starts to play, you look at the guitarist and you feel this terrible tickle start in your throat. It must have been awful.’ 3. Valuing feelings: clients may feel ashamed or embarrassed about showing their feelings and may apologise or try to change the subject. But if we can express a feeling, and have it heard and witnessed, we can often then see and feel it enough to move through it. The voice practitioner can help in this, e.g. Client: ‘I’m just a complete failure, I can’t even stand up and make a simple speech at a family gathering. I’m sorry, I know I’m being ridiculous.’ Practitioner: ‘But it sounds like that made you feel inadequate at an important family event, and that’s really hard.’ 4. Using reflection/paraphrasing: this is much more than parroting. You can pick up words or a phrase that feels important to the client, e.g. ‘Just now you said that you never felt confident to speak in your own family’; ‘You don’t feel this croaky voice allows you to be the real you.’ Paraphrasing allows a client to hear what he is saying, as well as showing that you are really following what he may be expressing or struggling to express.

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5. Careful questions: clients may feel interrogated if questions come too frequently, and this may stop them exploring for themselves or reflecting on their own words. Traditional counselling training encourages the use of sensitive phrasing in questions needed to check something out. Softening the question, by tone of voice or actual structure is recommended, e.g. ‘I’m wondering whether . . .’, ‘It feels like maybe . . .?’ or the use of open questions such as ‘How did you feel about that?’, ‘What sort of thing was going on around that time?’. 6. Silence and space: most voice practitioners like to give voice, and I have long had to keep my verbose nature in check in sessions. Silence and space enable a client to follow a thought, or allow a new one to bubble up and connect to a new feeling. We tend not to allow much silence in social conversation; in listening to a person in distress, silent attention can be very helpful as someone struggles to understand her thoughts or feelings. If a client seems really stuck, a gentle question such as ‘What’s going on for you at the moment?’ can help. 7. Summarise: giving a summary of what has been said at appropriate times during a session and, at the end, is very valuable. I invariably use that as a conclusion. ‘OK, so today we’ve covered . . . and you found that . . . so what you’re going to do is. . . . Is that right?’ It allows us to check out our understanding of what has been said, shows the client that we are ‘travelling with them’, and allows an ending of the session to be made. These skills may feel contrived if you are new to using them but they can be extremely effective tools in supporting any client from government minister to young singing student. For those who want to train in counselling skills, there are many part-time courses available in a variety of approaches, some of which are described below.

Trained professional help Sometimes a client’s distress or disturbance is of such a nature that the voice practitioner recognises that specialist help is needed. Clients who appear very depressed, anxious, disturbed or obsessional should be encouraged to go to see a doctor, because they are trained in the recognition of serious psychological disturbance, and will usually have practical ideas for management or referral. Some clients, however, are strongly resistant to ‘going the medical route’, and want to discuss other options for support and insight. The opportunity to talk about personal life issues with the right skilled trained professional can be valuable to many people. It offers the chance to recognise and transform pains, blocks and confusions, and can lead to new sense of control and power. Rather than a solace for emotional inadequacy, psychological therapy has come to be seen by many as a positive adjunct to a responsible life. There is an increasing and gratifying openness for ‘successful’ people to mention their own experiences; author Nick Hornby described how before psychotherapy he had been ‘aimless and stuck’, and could not have written his bestselling ‘Fever Pitch’ without his experience of therapy (BBC Radio 4 Desert Island Discs 3 October 2003). Such statements encourage others to at least consider some professional support, and I have been glad to quote Hornby when discussing counselling with a distressed ‘macho male’ client.

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There are a bewildering number of therapies available. We can go into a full psychoanalysis with sessions four or five times a week over many years or choose to have six sessions of highly structured cognitive–behavioural therapy with an intense focus on specific problemsolving. We can lie on a couch and free associate, sit face to face with the therapist and talk though our feelings, try out new techniques in ways of thinking, do deep breathing in a rebirthing process – and much more. What is very important is that any therapist whom we see is highly trained and sanctioned in some way by a professional organisation.

Choosing the psychological support Many medical practices now have counsellors as part of their team, and these can provide a simple first port of call. Although they generally only offer a few sessions, these are free of charge in the UK and can lead to further suggestions for support. However, many people do not want to go the medical route, and choose to see a private therapist. Unless seen by a student counselling service or charitable foundation, most clients will have to pay for psychological therapy and fees vary. Some clients have clear views on the kind of support that they want, but others ask for recommendations. Some voice practitioners recommend a specific therapist; I rarely do this, believing that I cannot know exactly what therapy might be right for a client and that the search for the ‘right’ therapist is part of an individual’s therapeutic journey. However, I do offer practical guidance on how to find a qualified and responsible independent therapist, in three main ways: 1. I may give a client a brief list of the main types of therapy (see below), suggest that she looks at one of the books available on the subject, or reads the internet Encarta description of different psychological therapies (see in websites list in Appendix I). These can give clients a sense of the different methods, and they often recognise that they are drawn to one rather than another. 2. I may suggest that the client contact a national professional membership organisation for psychologists, counsellors or therapists. In the UK these include the British Association for Counselling and Psychotherapy, the UK Council for Psychotherapy and the British Association for Behavioural and Cognitive Psychotherapies (all websites listed in Appendix I). These organisations provide lists of trained and registered therapists working in any geographical area of the UK, with details of the training and special interests of each. Other countries are likely to have similar, and voice practitioners can research this, so that they have the contact details available. 3. Once the client has a list of local contacts, I suggest that she telephone any that sound possible, to ask a few questions. Each therapist’s voice, manner and conversation will help the client to decide whether or not to book a session – and that session will help guide a decision as to whether to continue.

Psychological therapies Psychiatrists Psychiatrists have had medical training as doctors and, depending on their training and interests, will use a mixture of drug treatments and psychotherapy. A client is likely to be

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referred to a psychiatrist through a general doctor, and will usually be seen in a clinical setting. Psychiatrists deal with adults and children who have a significant emotional disturbance, and will head any team managing those with severe mental illness. Psychiatric support is offered as part of the NHS in the UK, so clients will not pay for consultation and treatment. Some psychiatrists choose to train as psychotherapists.

Psychotherapists and counsellors It is not always possible to make a clear-cut distinction between these two groups, because this often relates to the intensity and orientation of the training. Approaches are based on different theories about the source of distress and the methods needed to change it. The training is often long and deep, and may involve an intensive taught course, personal therapy and long-term supervision. However, there are many different methods, and some forms of therapy have relatively short training and may not insist on personal therapy for the practitioner. Although fees vary, clients will need to pay for therapy with these professionals. Most counsellors and therapists do not come from a medical background. Both groups may be referred to as ‘therapists’ by the general public and, in this chapter, I use this word as an abbreviation for both.

Main approaches in psychotherapy/counselling Transactional analysis therapist Katarina Gildebrand says ‘when you look at any master therapist at work it is may be difficult to tell in which approach she has trained, for she is likely to have evolved an eclectic way of working’ (personal communication, 2006). This is true for many good therapists who mix and match from different philosophies and methodologies. Nevertheless we can broadly identify three ancestral lines for the psychotherapies now available: psychoanalytic, behavioural and humanistic. Therapists in each group vary significantly in their practices, and may work with individuals, couples, families or group contexts.

Psychoanalytical/Psychodynamic approaches Psychoanalytic theory originated in the work of Freud and was developed by Jung, Adler and other early psychoanalysts. An analyst uses a detached perspective to analyse what is ‘going on’ for a client, helping him to get in touch with repressed or unconscious memories and motivations. The focus is on why a client feels or behaves in certain ways; the aim is to increase a client’s understanding of himself and his past so that he has the choice to live life differently. The main method used has always been free association in talking, allowing anything to be said and followed through, with the trust that it is all relevant to the growth of the person. Analytical psychotherapy may take many months or years. The work of Woodman (1985) is rooted in Jung, but has a particular emphasis on the way the body stores and expresses feelings. Typical emphases: early childhood experiences; the mother–child relationship; concepts of defence mechanisms within the client; the nature of the relationship between the analyst and the client, including the idea of transference.

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Humanistic therapy approaches The underpinning philosophy of these approaches is that human beings have an innate drive to grow and develop in terms of psychological growth towards completion and integration. The relationship between the therapist and the client is seen as equal, with the client holding her own answers, which the therapist helps her to discover through a wide range of diverse techniques. The therapist is active in questions and suggestions, but always with a deep ‘positive unconditional regard’ (Rogers 1961) for the client and how he might facilitate his personal growth and development. The original rogerian person-centred therapy, transactional analysis, psychosynthesis, Moreno’s psychodrama and gestalt all belong under the heading of this approach. Typical emphases: although my own period of therapy was with a Jungian analyst, this statement of Carl Rogers is an inspiration to my own work: If I can create a relationship characterized on my part: by a genuineness and transparency, in which I am my real feelings; by a warm acceptance and prizing of the other person as a separate individual; by a sensitive ability to see his world and himself as he sees them, then the other person in that relationship: will experience and understand parts of him/herself which previously he/she has repressed; will find him/herself better integrated and more able to function effectively; will become more similar to the person s/he would like to be; will be more self-directing and self-confident; will become more of a person, more unique and more self-expressive; will be more understanding and more accepting of others; will be able to cope with the problems of life more adequately and more comfortably. I believe that this statement holds true whether I am speaking of my relationship with a client, with a group of students or staff members, with my family or with my children. On Becoming A Person Carl Rogers (1961)

Behavioural approaches The behavioural approach to therapy developed soon after Freud’s initial work but the focus here is on what can be done to change behaviour, which is seen as the result of learning, conditioning and what we believe – all of which can be changed, resulting in a change in feelings. Sessions are highly structured and goal directed, and based on developing new strategies of thinking. The different methods have a number of particular exercises, techniques and homework that they suggest to clients. Many approaches claim to be able to help clients significantly in four to six sessions. Behavioural therapy was originally used in the treatment of phobias and obsessive behaviours, but is now used widely for many different issues. Cognitive–behavioural therapy (CBT), neurolinguistic programming (NLP), and brief or solution-focused therapy belong in this approach, as do many of the practical ideas of the personal life coaching. There are often short courses available within these groups and they can provide very useful ideas and techniques that can be used by voice practitioners in their work with clients. Typical emphases: use of strategies to think about beliefs and function, e.g. core solution focus therapy questions might include: ‘Imagine there is a miracle one night and when you wake up everything is as you would want it. What would be different and what steps might

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make this happen?’ NLP techniques include the useful ‘anchor’, where a strong association is set up between a simple physical gesture and an intense positive memory; using that gesture allows a client to connect to the sensations of that memory at stressful or challenging times.

New therapy methods Therapy methods continue to develop, use and adapt methods from all these original approaches. Narrative therapy developed in Australia during the 1970s and 1980s, and it is widely used in that country. Its central tenet is that our identities are shaped by the accounts of our lives found in our stories or narratives. A narrative therapist works with clients to encourage them both to tell and ‘re-story’ their experiences. Another new approach is that of sensorimotor psychotherapy, which has the body as the main focus of activity. This ‘blends theory and technique from cognitive and dynamic therapy with straightforward somatic awareness and movement interventions such as helping clients become aware of their bodies, track bodily sensations and implement physical actions that promote empowerment and competency’ (Ogden et al 2006). The techniques are varied but include emotional freedom techniques, where clients stimulate energy meridian points on the body by specific fingertip tapping, and eye movement desensitisation and reprocessing (EMDR), involving the training of specific eye movements. Clinical trials have demonstrated EMDR’s efficacy in the treatment of post-traumatic stress disorder.

Conclusion A weight of concern and responsibility is often lifted from a concerned voice practitioner when a troubled client starts seeing a good therapist. The client may want to talk about her new process of emotional support and growth in voice sessions, but this should generally be limited, because the two professional roles can and should be parallel but separate. It can, however, sometimes be useful for voice and psychotherapy professionals to speak to each other about the client’s process – always with that person’s permission of course. For some people, voice work itself seems to precipitate a psychological change.

Client story: Annette Annette was a teacher in her late 40s who developed soft vocal fold nodules. These resolved with six sessions of voice therapy, but during the process Annette became increasingly interested in the metaphor that finding her voice had at deep levels in her own life. Part of this became a search for deeper knowledge of her mother, who had died 6 years earlier. She had come to England as a young Lithuanian refugee after the last war, married Annette’s father and never returned to her home country. As far as Annette knew, she never used her own language again, something Annette came to see as a deep loss for her mother. ‘She never found her voice again, and I feel as if I’ve never

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found mine either,’ she said to me. Annette began an intense personal journey of self and family discovery, and entered a dark area of distress, during which for the first time she started to keep a journal. After an emotionally powerful journey to Lithuania to find her mother’s roots, she showed me her written account of her experiences. I felt that it was important that she have some professional psychological support with what she was going through, and urged her to do this. Although at first wary of the idea, Annette did follow my suggestion and found a good counsellor with whom she spoke at deep levels. Her writing continued to develop, and she joined a local writers’ group. Her work has now been both published and broadcast and in a telephone conversation she told me ‘I really have found my voice through this, and it all started with those breathing exercises’.

Part 5

Practical voice work

Introduction The focus of this section is on what we can do to change voices. Chapters 16 and 17 offer ideas for practical voice care and general bodywork. Chapters 18–25 then describe a number of exercises and suggestions that relate to each of the eight aspects of voice. Although many of the ideas can be adapted for work with more than one person, Chapter 26 offers a range of specific ideas for group work. Most of these exercises have developed from my own voice exploration and from years of work with clients. Some have been learnt or adapted from other voice practitioners; whenever possible I have credited a specific exercise to the relevant teacher, and no plagiarism is intended. There are of course many excellent books that contain exercises specific to your own voice specialism. The ideas come from technical, imaginative and textual approaches, but sometimes an exercise mixes all three: 1. Technical ideas are specific physical instructions designed to have an effect on particular aspects of voice such as breath control, pitch range, vocal onset, etc. 2. Imaginative ideas use a metaphor or image to explore a particular aspect of voice (e.g. breathe in through your toes) or involve a longer imagination exercise or group work improvisation. 3. Text ideas require speakers to use their voices in other people’s written words, from book, poetry, song, play extract or other material. Some exercises are short and some are long; some need quiet solitude and reflection, and others provide an instant change in awareness and voice. Some exercises demand conscious physical effort, whereas others involve a simple release into a new connection or a sideways discovery. The focus is on practical action, but any voice work may open a door that allows a client’s emotions to come to the surface. It is implicitly assumed that the voice practitioner will attend to any emotional issues that arise, allowing people to talk about their lives and feelings when necessary.

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The organisation of the exercises The idea is that, having heard and identified aspects of voice that need work, you can scan though each chapter to find ideas and inspiration. Although organised under the Voice Skills headings, most exercises of course work on several aspects of voice. In Body exercise 26: To loosen and warm-up the body: limb shake, we release the arm and leg muscles and find that breath is changed and so is the tension along the channel. This is inevitable given the holistic connected nature of voice and voice work. The chapter headings are a way in to viewing and accessing practical ideas, and can be seen as a starting point in choosing work for adult or child, individual or group. The wording aims to give you, as voice practitioner, the gist of an exercise in a way that is as clear and economically expressed as possible. It is assumed that you are already familiar with how to work with another’s voice, and are likely to adapt most exercises into your own words to make them your own. Most of us rarely repeat an exercise in exactly the same way, so they continue to change and develop. Some exercises are demonstrated on the linked website but it is clearly impossible to include them all. There is no intention to impose a progression in a section or chapter, and the collection is deliberately mixed and eclectic. Sometimes, when we look quickly or askance at something, the right thing ‘jumps off the page’. Most exercises in this section are numbered and named by an aim and a brief title, e.g. Pitch 9: To extend the pitch range: exploration with piano or keyboard. The aims are based on considerable anecdotal findings and experiential observation that such exercises can change vocal production and qualities. As we saw in Chapter 2, the effectiveness of voice exercises in the arts world to change vocal production and sound is generally judged on what is seen, heard and felt. In the clinical voice world there is an increasing requirement to prove that an exercise achieves a particular aim by testing the results using strict science criteria. ‘Ideally speech–language pathologists should conduct voice therapy on the basis of procedures that are known, through research evidence, to be effective’ (Mathieson 2001). Interesting investigations continue, but, given the number of voice exercises in use – and the fact that some things in life are not amenable to scientific testing – it is unlikely that this aim will ever be completely realised. After some exercises or suggestions you will see general comments, or relevant quotes from other voice practitioners.

Important note about safety and responsibility Any practical physical work to change the behaviour of another person carries a potential risk. These exercises are only suggestions; you will have the responsibility for the comfort and physical wellbeing of your client or group.

Chapter 16

Practical voice care

Saint Blaise was a doctor and bishop in the third century ad who healed a child in whose throat a bone had stuck. Croatian otolaryngologists have chosen him as the patron saint of those with throat diseases and he is celebrated on 3 February every year. Whatever our belief in spiritual healing, practical steps are also needed to protect and sometimes improve the physical structures of the vocal mechanism. Clinicians sometimes refer to this as ‘vocal hygiene’; I prefer the term ‘practical voice care’. There are three sections in this chapter. The first lists a number of voice care strategies under alphabetically organised headings; these are generally addressed to the client, so use the ‘you’ pronoun. At times all voice practitioners are asked to advise clients on such issues, and many produce their own ‘dos and don’ts’ lists. The second section gives an example of a handout specifically designed for actors and singers. The third describes some of the facts that underpin the practical suggestions.

Practical advice Alcohol 1. Drink in moderation and, if there is a significant voice problem, drink very little or not at all until the voice improves. 2. Particularly avoid spirits or any other drink with a high alcohol content. 3. If you really need that drink, have a glass of water alongside every alcoholic drink that you have. 4. Never drink alcohol before a performance or important speech; there are effects on concentration and awareness as well as voice!

Aspirin 1. Unless a doctor has prescribed it, avoid taking aspirin or a medication that contains it, or gargling with aspirin, if you are facing any imminent demanding vocal task.

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Asthma 1. If you have regular wheezing, coughing or shortness of breath, go to see a doctor. 2. Steroid asthma inhalers sometimes affect both vocal folds and voice. These should never be discontinued but talk to your specialist if your voice seems worse with a particular inhaler. 3. Know how best to protect your vocal folds after inhaling. Using a big ‘spacer’ inhaler, washing the mouth out or steam inhaling after inhalation can all help. 4. Be careful with any breathing exercises. (Note to practitioners: if taking a group class, ensure that anyone with asthma can take responsibility for herself and not attempt any particularly strenuous breathing exercises, unless confident that these will do no harm.) 5. If you are drawn to singing, research evidence suggests that it may be beneficial!

Caffeine 1. Drink real coffee in moderation; one a day is ideal and three cups should be the limit. If you can bear to change to decaffeinated coffee, do! 2. Remember that many ‘cola’ drinks contain high levels of caffeine; check the cans and keep this to a minimum. 3. If you are someone for whom caffeine is essential to life, speech and language therapist Claire Wonnacott suggests drinking a mug of water while waiting for the kettle or coffee machine to be ready. You are then what she calls ‘liquid neutral’ (personal communication, 2007).

Chocolate 1. Eat chocolate in moderation, and try to make it the best quality (high cocoa content). 2. Observe the effects of chocolate on your own mouth and throat; if you notice that it produces a sensation of sticky saliva or mucus, indigestion or reflux, do not eat it. If you are addicted to it, at least avoid chocolate at any time near to important voicing commitments. 3. Remember that chocolate does contain caffeine, which can affect sleeping, so don’t eat too much in the 3 hours before bed if you have any tendency to insomnia.

Cold weather ‘Wear a warm scarf round your throat and mouth if you go out with a cold, and always if you are a singer’ is an old fashioned adage, and there is no good research evidence that it helps protect the voice. Nevertheless there are three practical reasons to at least consider this:

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1. Keeping the neck warm lessens the tendency of the neck and laryngeal muscles to tighten as a reaction to the sudden cold air; this can be relevant if you have a pattern of excess laryngeal and neck muscle tension. 2. A scarf over your mouth and nose will help warm the air as you breathe in and may possibly filter out some of the larger irritating dirt particles. 3. If the immune system is fighting an infection, it is sensible not to place extra strain on the body by quickly varying extremes of temperature, so keeping warm generally makes sense.

Colds and coughs and clearing the throat Managing the occasional cold and cough 1. The general advice must always be that, if a cold, cough or flu makes you feel really unwell, you should try to go to bed, or at least rest so that the immune system can focus on fighting the infection. See your doctor if you continue to be ill. 2. Increase your water intake and use steam inhalation. Both of these steps (described under Hydration) keep the body from dehydration, and support lubrication for dry throat and vocal folds. 3. Be sensible about exercise and demanding activities such as performing. The sports medicine ‘Neck Check’ advises that, if your symptoms are mainly above the neck (runny eyes and nose, a sore throat or a thick head), light exercise can be taken for 10 minutes, but you should of course stop if you feel unwell or exhausted. If the symptoms also seem to be below the neck (aching muscles, a temperature and general body sweating) you should not take vigorous exercise because you might have a viral infection and should rest to recover. 4. If you believe that they help, take vitamin C, zinc and echinacea, said by some to boost the immune system. Evidence is inconclusive but, so long as none is taken in excess, it will do no harm and may help your morale. 5. Do not take too many antiseptic throat lozenges, which are designed to try to discourage local mouth and back-of-throat bacteria, and may contain a substance to dull the pain. The frequency suggested by the manufacturers must be followed (often limited to every 4 hours). These are not general throat lubricants, which should only be simple fruit throat sweets. No lozenge or sweet can reach your vocal folds, and steam inhaling is always more effective.

Long-term habitual coughing and throat clearing 1. Steam inhaling and increased water intake: these keep up hydration and lubrication levels. 2. Monitor your own throat clearing or coughing. Count – or ask another to do so – how many times you do this in an hour. Become aware of your pattern and try to lessen it – even slightly. If coughing or throat clearing has become a habitual behaviour, set increasing periods to stop yourself from coughing or clearing your throat.

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3. Explore alternatives to coughing or throat clearing. Suggestions are: – swallow twice – the first time may squeeze the mucus up from the vocal folds and the second may move it up and over the epiglottis where it can go down the oesophagus to the stomach – yawn and swallow – do a very quiet downward pitched mmm, and then swallow – open the throat in a wide silent yawn, and then strongly ‘huff’ the air out by a strong contraction of the abdominal muscles; this may help blow the mucus off the folds, but sometimes precipitates a cough, so use with caution. – hold your breath and deliberately tighten in the throat area, and then swallow – sometimes you have to clear the throat of phlegm or an irritation; cough or throat clear as gently and quietly as possible.

Diet If you suspect that a particular food or drink is contributing to a voice, throat, nasal or digestive problem, try to cut it out completely for a month at least. At the end of that time, if there is no improvement, it is unlikely to be a major causative factor in the problem, but consider a consultation with a nutrition specialist.

Exercise Exercise can help release both bodily and emotional tension. Consider options that appeal to you if you take none. Ask your doctor’s advice if you have any medical problems.

Gargling Gargling can help an ‘upper’ throat problem but will never reach the vocal folds. Increased water intake and steam inhaling are much more effective for ‘an irritable throat’. These avoid the strained head/neck alignment that is an inevitable posture in gargling. If you have any voice problem, do not use drying salt water gargles or aspirin.

Hydration 1. Try to drink six to eight glasses of water each day, spacing this out over the day. You can drink this in the form of squash if this is easier. 2. Use steam inhaling: fill a steam-inhaling mug with just boiled water from the kettle. Place your nose and mouth against the plastic face mould and breathe normally for around 10–15 minutes. There is no need to take deep or frequent breaths, and do not worry if

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the steam does not feel hot – there are usually air slits in the face mould to allow cool air to enter. The steam will still be reaching your throat. You will be able to read or watch television at the same time, but you will need to top up the water from a just boiled kettle (or reheat in a microwave) two or three times in 15 minutes as the water inevitably cools and loses the steam. After steaming, allow at least 30–60 minutes before using your voice in any strong or public setting. The throat and vocal folds need time to cool down, and for dilated blood vessels to close down. Do not add anything to this water unless you have a cold or throat infection, in which case two drops of olbas oil or tea tree oil can be added. Be careful – wait until these oils have spread into the water, and breathe with care initially, as both can create a burning sensation in the lining of nose or throat. (Note: always warn clients – they will be handling just boiled water and need to be extremely careful.) 3. Room humidity level: if a workplace or home has a very dry atmosphere, an electric humidifier can be helpful, and there is a wide range available. Even a shallow bowl of water or radiator ‘hook-over’ container can be of use to increase moisture levels. 4. Be aware that antihistamines (used in the treatments of allergies and some coughs) can have a drying effect on the respiratory tract, as can some nasal sprays and decongestants, and excessive alcohol and caffeine. Improving hydration can counteract these side effects. Sometimes doctor will prescribe a drug to increase moisture levels in the mouth and vocal tract.

Noise 1. Noisy environments will require you to raise the loudness level of your own voice. Either avoid talking when possible, or know how to ‘speak with support’, as safely as possible. 2. Keep up your water intake if you have to talk over excessive noise. 3. If your voice or throat feels strained after use against noise, use the steam inhaler. 4. If you have an option of a microphone when speaking or singing, use it, unless you are completely confident that it is not needed. Remember that an empty room has a completely different acoustic to a room full of people – bodies and soft surfaces absorb sound. 5. Even a car can have a high level of ambient noise from the engine. If you are a passenger, twisting the neck to talk to the driver can add to voice muscle strain; face forward or turn from the waist rather than the neck. 6. If you are a performer in a big show, get to know the ‘sound desk’ staff, and discuss any difficulties with microphones or vocal feedback.

Reflux 1. Specific foods that have been associated with reflux include coffee, tea, Coca-Cola and other carbonated beverages, citrus fruits and juice, tomatoes and tomato sauces, spicy

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2. 3.

4. 5.

6. 7.

8.

9. 10.

foods, peppermint, dry foods such as peanuts, and fatty foods such as ice-cream. If you think that these foods affect you, it is sensible to try cutting them out. Weight: reflux is more common in people who are overweight. I never advise a client to lose weight, but acting and singing teachers are not always so reticent! Eating late. Try to allow at least 2 hours between the last meal of the day and going to bed. This is impossible for the performing singer or actor but it is sensible to try to avoid very spicy foods at a late night meal, and then to try to have an hour before bed if possible. Cigarettes: the chemicals in cigarettes can relax the sphincter muscle and increase the likelihood of reflux. Some medicines can irritate the oesophagus. These include common painkillers such as ibuprofen and some other drugs. If you suspect that a medication is causing reflux, tell your doctor. Postures that involve extended periods of bending over or compressing the stomach can encourage reflux. Sleeping: if heartburn happens at night, it can help to raise the head of the bed by about 10 cm (by placing flat bricks under those two legs). This is a simple gravity device, and helps to keep the acid lower in the oesophagus. Just increasing the pillow height will tend to compress the neck as the chin comes forward. Traditional pain relief treatments for heartburn include drinking a large glass of water to try to dilute the low pH (acidic) levels in the stomach, or drinking a glass of warm water with one to two teaspoons of baking soda added. Bicarbonate of soda is alkaline and can help neutralise stomach acid. Even moderate stress can increase reflux, so take seriously any possible practical steps to minimise or manage it. Medical treatments may be prescribed by a doctor: – antacids are alkaline liquids or tablets that help to neutralise the acid in the stomach – proton pump inhibitors suppress the production of peptic acid; omeprazole is currently in common use and can be very effective, but the appropriate dosage is crucial – surgery: if the problem is very severe, a gastroenterologist may advise surgery.

Silence/’voice rest’ 1. If you have a cold, laryngitis or a cough, using your voice less than usual will help reduce the strain on those hard-working vocal folds. Even a silence of an hour or so at the end of a busy day before a social evening will save the folds from thousands of vibrations and, if accompanied by hydration steps and physical rest, can help the voice to recover slightly. 2. If you want to give your voice a complete rest, you may want to have a period of silence with no talking, whispering or singing. Two nights and a day can be a good stretch of time; any longer should be discussed with a voice professional, because it may not be helpful. It can be difficult to stay silent, and you may want to plan it beforehand. A sample voice rest guidance handout for clients is included at the end of Chapter 21.

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Smoking Stop smoking. There are many methods that can help you to stop; talk to your doctor or use the internet. If this is currently impossible for you, at least drastically cut down, and avoid spending time in smoky rooms. If you cannot yet give up cigarettes, do not speak as you exhale the smoke.

Example of specific advice handout for actors and singers in vocal trouble This covers both general protection and ‘emergency’ care, for when the performer knows that he has to be on stage in the imminent future.

General protection 1. DO drink water regularly throughout the day – aim for 1–2 litres each day (six to eight glasses) spread out during the day and evening. Many of us are dehydrated without realising this, and drinking water is important to moisturise the delicate mucous membranes of the throat and larynx. Don’t gulp water immediately before a performance or broadcast – you may burp! 2. DO use steam inhaling, with mug or electric steamer before you go to bed. After heavy vocal demands, the water vapour will moisturise your throat before you sleep. Use it in the day if you feel very dry, but never less than an hour before singing or acting. Always use a steam inhaler at the first sign of strain or inflammation; add some drops of antiseptic or tea tree oil only if you feel that you have an infection. 3. DO keep your room/dressing room somewhat humid if you can – your throat lining really likes a damp atmosphere. (Remember that if ever you have to fly shortly before a show, and drink lots of water on the flight). 4. DO remember to warm up before a performance to prepare your body, breath and channel muscles for the intense work that they will be doing. Doing this in the performance space can be helpful. 5. DO also consider a brief cool-down routine after an energetic performance. Voice muscles may retain an ‘up-tight’ setting after high-energy voicing. Several voiced yawns down your pitch range on a quietly groaned aah, followed by some downward gliding sounds on long eeh, vvv or rolled rrr can help release laryngeal clenching. Drop over from the waist and gently shake, stretch and rub any tight muscles to help the body to know that it is now ‘off stage and off duty’. 6. DO be aware of excess negative body tension before it grips you round the neck. Choose all or any of these options that feel right to you: – Stillness – lie down in the semi-supine position for at least 15 minutes and release. (Use the voice release tape we have made if you want.) – Activity – even if you are extremely active during a show, it may be help to take some unpressurised physical exercise during the day. If not, use the instant ‘Still Stretch Shake Swing Sway Lengthen’ routine – at socially appropriate moments in the day! – Treat yourself to the occasional massage if you like this.

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7. DO avoid smoking unless it is truly essential for your sanity, and then keep it to an absolute minimum. Even if it is, do not smoke for at least an hour before or after a show. Look SERIOUSLY into the different methods for giving up – as you know it is bad for you and your voice. Avoid being in a smoky atmosphere that can irritate your throat and vocal folds; if that is inevitable, be ‘precious’ about your throat – sit by an open window or ask people not to smoke next to you. 8. DO avoid habitual throat clearing. If you need to clear the throat, do it as gently as possible and yawn and swallow gently afterwards. 9. DO avoid alcohol before a performance. It has a drying effect on the lining of your throat, particularly port and spirits. Some believe that red wine is slightly better than white wine or champagne – but that is not a recommendation to drink! Even after a show, if you have to perform or do an interview next day, go easy on the alcohol – and keep drinking water as well. 10. DO be sensible about what and when you eat. Try to allow at least an hour before you go to bed after eating. Try to eat ‘simply and sensibly’ after a show, i.e. avoid any food that affects you. If you notice any regular indigestion symptoms, see your doctor; acid reflux can damage vocal folds and affect the voice. If you feel that dairy products seem to increase the mucus in nose and throat, stop for 4 weeks and see if it makes a difference. 11. DO avoid shouting or talking over noise anywhere without using the support muscles and an unconstricted throat. Professional performers are usually very conscious of healthy voice use in shows, but negative patterns of vocal tension in ordinary life can significantly affect the acting or singing voice. Be aware of your breath support in ordinary life. 12. DO keep the name and number of a good ENT specialist who sees private patients; you may need to contact him/her for immediate help in an emergency. 13. DO look after your body generally – using exercise or free movement to relax, and consulting a physical practitioner (masseur, osteopath, physiotherapist, acupuncturist or other when you recognise the need). 14. DO talk about feelings to a friend or family member, or even a skilled professional counsellor, if you are having a bad time. Sensible control of feelings is different to long-term bottling up, which can tighten muscles and sap energy.

Emergency voice care 1. Rest your voice when you can, i.e. use it as little as possible away from performing and, when you do talk, keep it quiet and well supported with no ‘hard attack’. Be sure to warm up gently and briefly before you act or sing, so that body and breath are fully engaged to support any fragility in your voice. 2. Increase your intake of water to 8–10 glasses a day. Use the steam inhaler twice a day for 15 minutes each time – morning and afternoon – but see above. Bath or shower twice a day – relaxing for muscles and yet more steam! 3. Stop smoking and drinking alcohol.

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4. Go to see your local doctor as soon as possible. If you are away from home, find out the name of a local doctor and go as soon as possible. Make it clear that your living depends on the quality of your voice. If you have a bacterial infection, antibiotics can help to stop it getting worse. Sometimes repeated antibiotics are prescribed; these may be appropriate for resistant bacteria, but are of no use for a viral infection, or when pain or voice problems are due to vocal strain. 5. Ideally, see an ENT specialist/laryngologist as soon as possible; if away from home, the company manager or front-of-house team may know a local contact. If not, call the British Association for Performing Arts Medicine (www.bapam.org.uk) in the UK or similar organisation in another country. They usually offer confidential support and referral to trained help. Follow every step and medication suggested. 6. Take time off if you need it – if the doctor says that you definitely need time off, negotiate that; it is a hard thing for a performer to have to do, but there is no shame involved. Everyone dealing with singers and actors knows that this is sometimes necessary. One show off early on may help healing. 7. See a recommended masseur or osteopath if you recognise that excess muscle tension may relevant. 8. Spend some time each day on the floor – stretching, releasing excess muscle tension and breathing in a slow calm way. 9. Try not to panic – you and your career will recover.

Facts behind the practices Alcohol Alcohol is dehydrating to the whole body, and ‘causes the larynx to become injected, i.e. congested with an abnormal accumulation of blood’ (Mathieson 2001). Laryngologist Professor Martin Birchall says that long-term regular heavy drinkers have an eight to ten times increased risk of developing cancer of the larynx (personal communication, 2006). Oral cancer is also more frequent.

Aspirin Aspirin has a side effect of thinning the blood and reducing the chance of clots forming. This is why small doses may be taken before a long-haul flight, or by those with an increased risk of stroke or heart attack. As aspirin interferes with clotting it can increase the likelihood of a haemorrhage, including in the vocal folds. The use of paracetamol or ibuprofen is safer (but see effects of ibuprofen on reflux).

Asthma Asthma is a common problem. The Asthma UK website reports that, in 2007, 5.2 million people (including 1.1 million children) were currently receiving treatment for asthma. This

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works out as one in five UK households having a person with asthma, so any voice practitioner may find himself working with a client who has the condition. People who have asthma experience an intermittent narrowing of their bronchial airways, so air cannot easily enter and leave the lungs. They experience difficulty in breathing, often accompanied by wheezing, coughing or increased mucus. It can be a severe life-long condition or mild and occasional, and an attack is sometimes precipitated by exercise or cold air. ‘Susceptible subjects hurrying to their evening performance in cold dry air may develop bronchospasm’ (Davies and Jahn 1998). For most people medication is successful in controlling their asthma. Some people with asthma have voice problems. This may be associated with the reduced vital capacity, so if the speaker is short of breath the voice may be strained. Vocal problems can also occur as a side effect of some of the drugs used to control asthma. Treatment often combines two kinds of drugs: the bronchodilators, to widen the tubes of the airways, and the steroids, which help to reduce inflammation along the tubes. Inhaled steroids can sometimes cause vocal muscle weakness, thinning of the vocal fold covering and inflammation if candida infection occurs. All can lead to increased breathiness, roughness and possibly fine pitch control change. Although the steroids are intended for the bronchi of the lungs, some particles inevitably land on the higher levels of the vocal tract. The use of a spacer can help. This is a large container; one end is a mouthpiece and the other is attached to the inhaler nozzle. Its use more powerfully propels the medication particles down the airways than does an ordinary inhaler, so that more can reach the lung tissues. Harris et al (1998) advise holding the breath after inhalation, because this helps to maximise the amount of steroid that reaches the lungs. It is also important to take preventive steps to ensure that as little steroid remains above the bronchi as possible. People should rinse out their mouths with water, and steam inhaling can help move the particles downwards. Sometimes vocal symptoms improve with a change of steroid medication; if you are working with an asthmatic singer or speaker who complains of vocal difficulties, it is always worth suggesting that she arrange a review from her asthma specialist. Before the advent of the very effective drugs, treatment was largely focused on breathing exercises – rarely recommended nowadays. Indeed there is a danger that an amateur instruction to someone with asthma to ‘take deep breaths’ may precipitate the airways to tighten. I have worked with many clients with asthma who have reported that a gentle focus on the outgoing breath (never on inspiration) helps them to feel ‘calmer’ and more in control of their breathing. Some practitioners believe that singing helps control asthma, possibly because of the benefits from the lower breath placing and the need to control airflow, and there is continuing research into this. The Buteyko treatment programme believes that most people with asthma ‘over-breathe’ and the method emphasises the need for shallow upper chest breathing.

Caffeine Coffee, tea, Coca-Cola, cocoa, high-energy drinks and some painkillers all contain caffeine. Coffee beans have the highest concentration, although there is variation between coffee

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plants. Dark-roast coffee has less caffeine than lighter and instant coffee has less than fresh ground. Caffeine is a stimulant for the heart and nervous system, and associated with feelings of increased energy. Too much may contribute to insomnia, headaches and dehydration, and may raise blood pressure. Excess caffeine increases urine production, thereby increasing water loss from the body. Some voice specialists advise stopping all coffee drinking, but research conclusions are that drinking 300 mg or less (one average-sized mug) a day has little diuretic effect. Armstrong (2002) states that, although caffeine is a mild diuretic: ‘there is no evidence that exercise, when combined with the consumption of caffeine or caffeinated beverages, will result in chronic dehydration, and this is contrary to the advice of most exercise physiologists, physicians and dieticians.’

Voice story: Ali Ali came to see me because his voice was feeling strained and dry during his eight shows each week. He was an experienced stage actor, who had never had vocal difficulty before and, having been cleared by an ENT check, he was mystified as to why he was having problems. Six months previously he stopped drinking any alcohol, and felt much better for it. However, he was now drinking 25 or more mugs of black coffee a day. I could not imagine how he managed so many when the show started at 7.30pm, but Ali talked me through each one! We discussed hydration and caffeine levels and agreed that, as Ali was probably quite addicted to the caffeine, he should not stop completely and suddenly. Over the next 3 weeks he slowly cut down to three weak decaff coffees a day. Although at first he had some bad withdrawal headaches, he found a huge improvement in his voice and sleeping pattern. He also used steam inhaling and increased his water intake. This client had excellent voice skills; the catalyst for change was his dramatic caffeine reduction.

Chocolate Many people love chocolate and I am often asked whether it is bad for voices. Singers often report that it seems to increase the production of sticky mucus, but research is needed to substantiate this. Chocolate lovers are sometimes reassured by the regular research that regularly appears in the popular press, reporting the health benefits of good quality dark chocolate. It is suggested that, as cocoa has nearly twice the antioxidants of red wine, eating chocolate will help to mop up the dangerous free radicals in the body. Usmani et al (2005) found that theobromine, a key ingredient of good quality dark chocolate, is almost a third more effective in stopping persistent coughs than the leading medicine codeine, and causes no drowsiness. However, we are not quite at the point when we can suggest to coughing clients that they eat quantities of dark chocolate!

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Coughs and colds It is of course possible to get a streaming cold with no cough, sore throat or laryngitis, but I am grouping these together because in general there are management strategies in common. In the medical world colds and coughs are often called upper respiratory tract infections (URTIs), and may be caused by viruses or bacterial infections. It is only the latter that can be helped by antibiotics, and a doctor cannot know which is relevant for an intractable cough or long-term laryngitis. Clients with voice disorders will sometimes have had two or more courses of antibiotics to no good effect. They may have had a virus, but a supplementary muscle tension voice problem may have developed after the ‘bug’ has gone. A speaker or singer may tell you that he has too much phlegm or mucus, and often think that this is coming down from his nose. But mucus around the vocal folds may have come from one or all of three areas in the respiratory system: 1. The nasal and head sinuses: mucus may be profuse in a cold, as the body tries to flush out irritation or infection. 2. Coughed up from the lungs and bronchi. 3. Produced by the cells just above the vocal folds as lubrication. The colour of the mucus is relevant; green or dark yellow may mean that there is an infection that may need medical treatment, whereas pale yellow or clear often indicates that the body is reacting to an inflammation or irritation. Pharmacists and doctors can advise on the various medications that can help the symptoms of streaming or blocked nose and sinuses. Decongestants and ‘drying-up’ treatments can dry the vocal folds, and steam inhaling can be a useful adjunct to such treatments. If the nose feels very blocked, a few drops of Olbas Oil (with menthol as a decongestant ingredient) or tea tree oil (reputedly a natural antiseptic) can be added to the steaming hot water. They should not be used if there is no cold, because they can have a drying effect on the lining of the throat and nose. Coughing is an important reflex, designed to get rid of an irritation such as mucus or a foreign body from the airways. The cough sequence is to take in a deep breath, close the vocal folds, and quickly contract the abdominal and between-ribs muscles. Pressure builds up under the vocal folds, which then strongly open as the larynx rises. The air is expelled under high pressure, so that any irritation can be moved out of the mouth or swallowed. We need to cough, but the act of coughing can be quite a violent vocal act, and long or excessive coughing can negatively affect the voice. Chronic long-lasting coughs are not uncommon, and often irritate the vocal folds. The most frequent causes are inflamed sinuses with postnasal drip, asthma, smoking and reflux. If a voice practitioner comes across any client with a chronic cough who is continually treating himself with an ‘over-the-counter’ cough medicine, he should be advised to seek a medical opinion. However, although serious illness must be ruled out, a strong habit can develop and become a long-term irritant. The more we cough, the more mucus is produced by the cells just above the vocal folds to soothe the irritation. Then we cough to clear that phlegm – and the cycle continues. But there may be no mucus at all; the cough simply becomes a habit and can be intensely irritating, to both sufferer and those around him. SLTs are often asked to advise such clients, and sometimes a pattern of laryngeal constriction may be a contribu-

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tor. Mathieson (2001) says ‘it seems to be inevitable that people who abuse their voices with vigour also clear their throats with considerable force’. She also describes the habitual noises of some voice abusers who have a ‘tendency to over-use the larynx as a sphincter’. These include grunting, huffing and constricted groaning (as opposed to the open throat groan that can be a good release). Eleven-year-old Jamie, described in Chapter 27, had a habit of such audible glottal closure when concentrating. Coughing can even become a ‘group event’. Entertainer Derren Brown (2006) writes that ‘by far the most reliable gauge of an audience’s interest is the extent to which they cough. A cough is sure sign that a person has detached a little from the show and is getting fidgety’. The late Sir Ralph Richardson is credited with saying ‘the art of good acting is preventing people from coughing’, but audience members do need to take responsibility for their own throats!

Diet There is a widespread view that dairy products can aggravate a tendency to excess mucus production, whereas spicy foods, caffeine and alcohol can contribute to the problems of reflux and its damaging effect on the vocal folds. Nutritional science is an expanding area, but as yet research on the specific effect of foods on the voice is limited. It is at least sensible to listen to an individual’s anecdotal experience here, and suggest cutting out any possible irritant for a month or two to see what happens. There are many food sensitivity tests available, which vary greatly in their accuracy, but many clients will seek out such tests, and follow the recommendations.

Exercise As has been emphasised, physical ability and vocal health are not synonymous, but I often ask clients whether they take any regular exercise, because it can be relevant for general muscle tone and breath patterns. Sometimes the postures, vocal demands and environment associated with a particular exercise can be relevant for voice. The head/neck alignment in the breaststroke swimming position can over-tighten the neck and extrinsic laryngeal muscles. Although karate can benefit body strength, stamina, breath and posture, one beginner voice client developed vocal strain as a result of overzealous solitary practice with the wrong movements and loud shouts. A 33-year-old non-smoking/non-drinking professional darts player developed very swollen vocal folds, which the ENT surgeon felt were linked to his long hours of practising in smoke-filled bars during his 20s.

Gargling Davies and Jahn (1998) confirm that gargling for voice problems ‘has little or no scientific validity’. The head and neck posture needed is not helpful and, although the liquid may

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warm and moisten the area around the tonsils, it never reaches the level of the larynx. Clients may not realise this. One actor told me that he had been told by a colleague to drink a glass of hot water, lemon and honey, and to tip his head back and ‘let the honey dribble down onto your vocal cords to soothe them’. Gargling should be used only if the back of the mouth and upper throat are affected by a painful or infective pharyngitis, when gargling with a good antiseptic/pain-relieving mouthwash can be helpful.

Hydration Laryngologist Garfield Davies used to tell clients that ‘the vocal folds are happiest in the atmosphere of the Kew Gardens hothouse’. The mucous membranes of the whole vocal tract need to be kept moist, to repel bacteria and to maintain health and flexibility. Davies and Jahn (1998) offer a disturbing view of the dried-out larynx which ‘may reveal the loss of the normal glistening appearance, and the presence of thick, mucoid secretions on the posterior pharyngeal wall. The vocal folds themselves appear dry, with clumps of white mucus on the surface, sometimes forming a string-like bridge across the maximum points of vibration’. Dehydration is not good for the voice! Clients need to appreciate that, if they speak with too much throat constriction, a tightly pulled back or immobile tongue, a clenched jaw or a habitual open-mouth breathing pattern, the vocal folds may experience excess friction and heat. Then the mucus-producing cells may produce too much or too little mucus. A hot dry atmosphere, or one that contains irritating fumes, will stimulate the same effect. The concept of ‘excess heat’ is seen as relevant to laryngeal disease in traditional Chinese medicine, and acupuncture is often used in its treatment. Yiu et al (2006) gave acupuncture to 24 clients who had voice disorders with ‘benign pathologies’. Half were placed in an experimental group, and received 10 intensive acupuncture sessions to three points that relate to improving throat problems and vocal function. The other half had acupuncture on two points not related to voicing. Significant improvements were found in the treatment group and these remained 2 weeks after completion of the acupuncture. There are three main hydration strategies: increasing water intake, steam inhalation and raising room humidity. Verdolini-Marston et al (1994) described how these lessen the viscosity (the thickness or stickiness) of vocal fold tissue, and the ‘energy loss during vocal fold vibrations’. Reduction in that viscosity also lessens the risk of vocal fold swelling. They found that hydration treatments were beneficial to six women with vocal nodules or polyps, and concluded that hydration and voice therapy should be complementary management strategies. Most centrally heated and air-conditioned rooms are likely to have air with a low relative humidity, i.e. there will be fewer water vapour molecules than in the open air outside that building. In aeroplanes that moisture level may be only between 5% and 10% of relative humidity, and 50% of the air may be recycled (Davies and Jahn 1998). They suggest that a performer arriving in a hotel room after a flight should immediately turn on the shower and leave it on until the room is full of steam, and repeat this after the performance.

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A Dutch study looked at the effects of inhaling dry air on the vocal fold comfort and efficiency in speakers with normal voices. Hemler et al (1997) found that all eight participants reported ‘unpleasant sensations in their airways and a subjective feeling of impaired voice production after inhalation of desiccated air’. Even after 10 minutes, acoustic measures showed that their vocal folds showed increased perturbation (small irregular vocal fold movements), causing slight pitch and loudness variations. Singers generally know the value of hydration. A newspaper reported that singer Phil Collins moved hotels for a concert performance in Hong Kong, because he had laryngitis and wanted a steam room in his £1000 a night suite. It does not need to cost so much! Finnish researcher Vilkman (1996) describes how a humidity level of around 65% can easily be reached by the use of ‘simple vaporising humidifiers in most of the working environments of professional voice users’. These can be bought through many of the big electrical outlets. It is generally suggested that around six to eight glasses of water a day is best for general hydration levels. Some practitioners suggest that we should check that we ‘pee pale’, a sign that the urine is adequately dilute. Water intake is also relevant for children who are more likely than adults to lose water by evaporation. Research findings suggest that dehydration can affect children’s general and dental health and can impair concentration and cognitive performance (www.water.org.uk). Steam inhaling with a towel-covered head over a basin of just boiled water is a traditional method to relieve a blocked nose or sinuses, sore throat or phlegm-filled chest. There are now easier ways that avoid the hot red face, limp damp hair and sensation of claustrophobic boredom. The simplest and most portable is a plastic steam-inhaling mug, sold in many chemists or pharmacies. There are different designs, but basically it is a plastic container with a mouthpiece-shaped lid to fit over the nose and mouth. A second option is the use of an electrical steam inhaler, which pumps out a steady stream of temperature-controlled water vapour. These used to be quite expensive but it is now possible to buy a reasonably priced combined device with facial sauna and steam inhaler attachments from some large commercial outlets (such as Argos in the UK). Professional voice users, including voice practitioners, public speakers and performers, should own one, because they can be an effective help for the inflamed or dry mucous membranes that occur when the voice is strained with fatigue, over-use or an infection. Steam inhaling allows heavily water saturated vapour to move into the mucous membrane cells of the vocal tract. I tell clients it is beneficial for the following reasons: • It ‘plumps up’ the cells of hot strained vocal folds and increases their flexibility and healing. • It puts moisture into the whole vocal tract. Extra moisture encourages relaxation of excess tension, and can be soothing after a cold or cough. It is also good as a night-time moisturiser after a noisy or smoky evening. • As a result of the extra moisture that is put in, the cells of the mucous membranes do not have to produce so much lubrication, so excess mucus produced by the cells just above the larynx may reduce. Two stories illustrate how effective hydration can be.

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Voice story: Kate Kate was a 35-year-old woman with Sjögren’s syndrome, which causes a general lack of body orifice secretions. Her mouth and the inside of her throat were continually sore and her voice strained, even though she used artificial saliva to help her mouth moisture levels. I suggested that she try the use of a bedroom humidifier and twice-daily steam inhaling, and she found this made a huge improvement to her comfort.

Voice story: Ambrose Ambrose was a 62-year-old dentist, who was a keen amateur baritone in a large choir. Over a period of 6 months he noticed a loss of power, vocal quality and pitch range in his singing voice. His doctor referred him to an ENT surgeon, who found nothing abnormal and suggested that age might be having ‘an inevitable and, I am afraid, irreversible effect’ on his singing voice. Ambrose arrived to see me somewhat depressed. During our initial chat, he told me that ‘sometimes my throat just feels too dry to speak, and I suppose that’s because I am straining my voice’. He did have a slightly shallow breath pattern and mild laryngeal constriction, but his fluid intake was very low: On waking – one cup of tea Mid-morning – one or two cups of strong coffee Lunch – occasionally a glass of juice, but usually no fluid intake with his sandwich. Late afternoon – possibly a cup of tea Early evening – a gin and tonic. Ambrose said ‘I’m medically trained and just didn’t realise how little I’m drinking’. He followed my suggestion of a 4-week hydration regimen of six to eight glasses of water a day and once-daily steam inhalation. At our second appointment he said that he was amazed at how much better things were. His singing voice was almost back to its old power and flexibility, and he also said that he felt that he had more energy generally. It might have been reasonable to assume that Ambrose was dry because he was straining his voice, but the analysis of his fluid intake made me suspect that the reverse might be true; he strained his voice because he was so dehydrated. It is always worth considering the options with a client who drinks very little.

Noise A report from the Royal National Institute for the Deaf (2004) found that, in 15 nightclubs in British cities, music noise levels were often at damaging levels. In some, the dance floor noise level was around 110 dB, and even in quieter areas noise levels averaged 92.3 dB. The cumulative effect on staff and regular clubbers could cause permanent hearing damage.

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Voice strain was not addressed, but is also a hazard in noise. Even a crowded restaurant with a hard acoustic (few soft surfaces to absorb the sound) can place demands on a tired or over-tight voice, and it is sometimes necessary to advise clients to avoid such environments. Examples of noise levels are to be found in Chapter 13.

Reflux Reflux occurs when gastric juice moves out of the stomach and up the oesophagus, if the valve at the bottom of the oesophagus is not adequately closed. Many of us may have occasionally experienced this when a burp of air seems also to contain an unpleasant acidic taste or even fluid, and some people regularly experience the discomfort of heartburn. This pain is not caused by heart problems, but may be felt in the chest, neck, throat or even angle of the jaw. In some people reflux is common and severe. If the acid tips down onto the larynx (LPR – laryngopharyngeal reflux), it may damage the vocal folds and cause voice problems and a chronic cough. The conference report of the Fifth International Symposium on Human Pepsin (Koufman 2004) describes Professor Jamie Koufman’s views that it is normal for the oesophagus to experience 50 episodes of gastric juice reflux each day, usually with little negative effect. But even three episodes of reflux can cause damage to the larynx, as the pepsin (a core component of the gastric juice) burns the covering. Koufman and Carter Wright (2006) state that ‘it has been estimated that half of otolaryngology patients with laryngeal and voice disorders have laryyngopharyngeal reflux (LPR) as the primary cause or a significant etiologic co-factor’. ENT specialists may diagnose reflux if they see particular patterns of red inflammation at the back of the vocal folds and within the larynx. Many people will have no apparent symptoms of reflux, but all voice practitioners should be aware that reflux can cause voice problems; many performers regularly eat and drink alcohol late, and both are strong precipitating factors for reflux. Symptoms of possible reflux include: • • • • • • • • • • •

chronic or intermittent voice problems a tendency for the voice to be worse in the morning an unpleasant taste in the mouth, particularly in the morning excess saliva frequent stomach bloating or belching heartburn-type pain frequent cough or throat clearing increased coughing or throat clearing after eating excessive throat mucus the sensation of a ‘lump in the throat’ wheezing or asthma-like symptoms.

All these symptoms can have other causes, but reflux needs to be excluded and it can often be easily treated, so if a client or student complains about two or more of the above a voice practitioner should suggest a visit to the doctor.

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Silence/’voice rest’ The vocal folds close every time that we swallow, and this has no harmful effect on them. Evidence suggests that their structure is affected by hard compression and ‘shear’ stress – as can happen when we cough, clear our throat or produce a loud strained voice. Voice rest is a term often used by ENT surgeons, nurses and SLTs. It has two meanings: • A period of complete silence, with absolutely no talking, whispering or singing and, as far as possible, avoiding throat clearing and coughing. • The common-sense meaning – not talking over noisy environments, not shouting, not talking all day long, allowing some periods of silence during a day, avoiding late nights and noisy evenings, etc. In the ‘old days’, laryngologists would sometimes prescribe weeks of silence to cure nodules or other vocal fold damage. This was difficult for clients on practical and psychological grounds. Nowadays, complete voice rest is generally suggested for short periods only, often after vocal fold surgery. A 36-hour period of complete silence might be suggested if there is a lot of short-term vocal fold swelling clearly caused by misuse. This can start a process of recovery and may be appropriate for any heavy voice user. Even an exhausted musical theatre singer in the middle of a long run can, with planning, be silent for the hours from midnight on Saturday until 12 midday on Monday morning, when she can then warmup her voice into normal function. As yet been no formal research into voice rest after surgery to the edges of the vocal folds, but most ENT specialists suggest at last some silence to allow healing of the delicate tissues that have been cut or treated with a laser; this prevents the repeated contact of those areas that inevitably occurs in voicing. Mr John Rubin generally recommends between 3 and 7 days silence, depending on the surgery, followed by 2 weeks of very limited voicing (personal communication, 2007). Whispering is not usually suggested because there is a danger of excess constriction as the speaker tries to make himself loud enough. However, there is a big difference between tight constricted whisper and soft whisper, where there is no excess tightening and adequate lip movements help to project the words. Laryngologist Markus Hess says that he does not forbid whispering after vocal fold surgery but makes sure that people know how to do it safely (Markus Hess, personal communication, 2005). Tight versus easy whispering.

Smoking The days are long gone when cigarette advertisements told smokers that cigarettes cleared the lungs. Smoking affects the voice because the substances in inhaled tobacco dry and irritate the mucous membranes and changes in the cellular structure can then result. Cannabis and other inhaled drugs have similar effects. Abitbol (2006) believes that there is more damage done to the vocal folds if someone speaks while exhaling smoke. As the vocal folds close, nicotine can infiltrate the mucous membrane of the vibrating folds. ‘Voice professionals who smoke during their phonatory

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activity are more subject to laryngeal lesions than someone who smokes at his computer without talking.’ Options for stopping smoking are now numerous, and there are various help lines and clinics where smokers can find information, practical advice and support. Few classical singers smoke, many pop singers and actors do, and there are some people who feel that cigarettes are an essential part of life. Voice practitioners usually advise clients to give up smoking, but the psychology of the individual needs to be taken into account, and some modifications may need to be considered.

Voice story: Jack Jack was a 28-year-old songwriter, singer and music producer, who came to see me because his singing voice had been unreliable for several months. He did not drink alcohol, but was a heavy smoker (30 a day) and drank around 4 litres of Coca-Cola each day as he worked. We discussed the effects of caffeine on his throat and voice, and he cut down on the Coca-Cola, substituting fruit squash when possible. We also talked about how Jack might reduce his smoking, but I understood his feelings about how hard this would be at this point in his life. He was currently very stressed by his workload, worked long hours alongside a partner who also smoked and said ‘the problem is, cigarettes are now my only way of calming down’. We agreed that, although clearly meditation and yoga would be healthier ways of staying calm, for the moment he simply was not going to give up smoking. We therefore looked at how he might lessen the impact of the smoke, and agreed that he would no longer smoke in either his bedroom or his studio. We know that a smoke-filled room damages non-smokers’ health by passive smoking. Smokers have both active (inhaling cigarettes) and passive (living permanently in smoke-filled rooms) damage, and lessening the latter is always a good interim strategy. At our next session Jack said that he now woke up feeling better, ‘less blocked and thick headed’, and enjoyed the new smoke-free environment of his music studio. I respected this client’s needs and process and his desire to give up smoking when possible.

The most commonly used method of stopping smoking is the hard journey of ‘cold turkey’ or plain will power, but this can be greatly supported by the use of nicotine replacement therapy. This may be delivered through the skin, via patches or sprays, or through chewing gum, lozenges, capsules or inhaler; Abitbol (2006) makes an interesting point relevant for performers when he writes that patches are better than nicotine chewing gum, which dries the salivary glands, irritates the base of the tongue and can dry the vocal folds. Other smoking reduction methods used include hypnosis, acupuncture, medication, glucose tablets and various methods of psychological support. Inhaled nicotine goes directly to the brain and is highly physically addictive. Smoking is also emotionally addictive; as one client said ‘I know it’s sad but cigarettes feel like my best friend, always there and utterly undemanding’. A voice practitioner can play an important role in supporting a client to cut down or give up; some clients need gentle supportive understanding, whereas others need the straight-talking approach of ‘you are mad to continue smoking because it is clearly damaging your vocal folds, your voice and your career – and is highly likely to damage your life’.

Chapter 17

General bodywork

Bodywork is defined here as direct action taken by an individual, or by a practitioner working with that individual, to change physical and emotional sensations and improve bodily awareness, feeling, functioning, health or energy. It is different to the general physical exercise that encourages the cardiovascular and muscular fitness so important for general health, and helps to manage excess psychological and bodily tension. The release of exercise-related endorphins contributes to a sense of balance and well-being. Bodywork certainly aims to improve health and function, but it also encourages a person to be ‘in touch’ with their posture and tension, and with the links between emotional and bodily health. Literally not knowing how we feel can be part of an unhealthy lack of awareness that may lead to increased stress and tension. In some cases it can result in a stress-related bodily disorder as ‘biography becomes biology’ (Myss 1997). Bodywork may involve learning particular body behaviours with a trainer (e.g. Alexander technique, yoga, t’ai chi, pilates) or experiencing specific ‘hands-on work’ with a trained practitioner (e.g. osteopathy, physiotherapy, massage). It results in an increased appreciation of what to do to make yourself feel better, and relates to the question that we may ask a client whose voice problem is likely to be connected to his stress levels – ‘what do you do to look after yourself?’. There is increasing recognition of the relevance of sensible ‘body management’ to health and emotional well-being. Large corporations have long had gyms but an increasing number now offer yoga, t’ai chi, massage, opportunities for power-naps and other activities previously seen as ‘too alternative.’ In a French business hotel a well-produced poster in my room offered advice on how to relax in a ‘Zen’ manner in 15 minutes. It suggested – with relevant cartoon drawings – 5 minutes ‘pour souffler’ (breathing), 5 minutes ‘pour s’etirer’ (stretching) and 5 minutes ‘pour se detendre’ (lying down). Certainly a healthier option than the mini-bar! As we have seen, the management of physical stress is highly relevant in voice work because it is difficult to free a voice in a tight body. Clients often need to talk about their feelings but sometimes a good first step is not a long discussion about how and why muscles are tense, but a good strong stretch. Bodywork involves the idea that we can take respon-

Voice Work: Art and Science in Changing Voices. Christina Shewell © 2009 Christina Shewell. ISBN: 978-0-470-01992-4

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sibility and direct action to maintain our bodies in as balanced and stress free a state as possible, to complement the medical model. There are a myriad number of bodywork fields; this chapter looks at some that have influenced my own practice and provide a ‘background’ for voice work: 1. 2. 3. 4. 5. 6. 7.

General relaxation The Alexander technique Martial arts Free movement: Five rhythms dancing (5Rhythms™) Massage Physical therapy.

There is no suggestion that those who work with voice should be expert in any of these fields, and any in-depth work is always best done by the appropriate trained practitioner in the area. However, aspects of these practices may inform our own approach to practical voice work.

General relaxation I have often watched doctors tell a nervous client about to have a laryngeal examination to ‘just relax’; it rarely works. When there is significant stress, it often takes time and a slower process to achieve a physical release. The aim of general relaxation is to let go of excess tension in the muscles and musculoskeletal system, and to encourage increased mental and emotional calm. Some people find this in stillness, others can relax only after movement and many of us need a mixture of both. We need to recognise what is best for an individual or a group; if we sense a collective exhaustion at the start of a voice class, a period of relaxing floor work may be appropriate before energising movement. Many still-body relaxation practices have developed from Edmund Jacobsen, whose book, Progressive Relaxation, was first published in 1929. Although he said that ‘to do away with all . . . tensions permanently would be to do away with living’, he pointed out that many people have ‘habitual generalised or specific muscle contractions that are unnecessary for physical or mental health’. He was one of the first writers to identify and describe the relevance of these patterns to ordinary life, and to develop steps to alleviate it. His approach had a strong influence on artists and musicians, as well as physical therapists and the medical profession. Jacobsen found that ‘when the unpractised person lies quietly on a couch, residual tension remains. . . . Usually he does not know what muscles are tense, cannot judge accurately whether he is relaxed, does not clearly realise that he should relax, and does not know how to do so anyway’. He found that people could learn how to let go if they went through a progressive sequence of deliberate tensing and release of various parts of the body in turn. Although not specifically directed at voice, he encouraged clients to be aware of tensions in the small muscles of their cheeks, lips, tongue, jaw, throat, chest, diaphragm and abdominal regions. His original training programme took months to complete, but has since been shortened. Practitioners claim that it produces a deep state of mental and physical

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relaxation, which can then help a variety of conditions, including chronic tightness in shoulders and neck, tension headaches, backaches, tightness in the jaw and insomnia. Although I tend to use a more gentle ‘unravelling’ kind of release, progressive relaxation is useful for clients who are very unaware of their muscle tensions, and for those who do not like imaginative exercises and want an explicit logical structure for bodywork. One barrister client was surprised to be told that he had unusually tight neck, shoulder and upper back muscles. A short tense and release progression helped him to gain more recognition and more control. It worked equally well with a client with a learning disability for whom the step-by-step structure was easy to follow on an individual cassette tape that I made for her. (A progressive relaxation sequence is included in Chapter 18.) The principle of ‘tense–let go’ is seen in the technique of negative practice, when we might ask a speaker to deliberately produce a very constricted voice, and then release that setting. A singer with a habit of ‘head poking’ would be asked to exaggerate this posture, and then to move straight into singing with better head–neck alignment. Negative practice helps a client to identify, control and change an undesirable pattern. Every stretch followed by release is based on the idea that maximum muscle fibre tension is likely to be followed by a response of maximum relaxation. There are now a multitude of books and self-help recordings about stress management, relaxation and positive thinking, and these can be accessed through bookshops and relevant websites. Once a method of deliberate relaxation has been learnt, an ‘anchor’ reminder can help to quickly access the body memory. An anchor is a neutral stimulus such as a movement, specific word or image that is deliberately associated with a positive memory or emotion. This stimulus can then act as an instant connector to that emotional state if needed. The term ‘anchoring’ is often used in NLP (neurolinguistic programming) work and has developed from the natural phenomenon when a sudden sensation, picture or sound connects us to a long ago feeling or memory. For instance, in a series of ever-deeper steps, we would guide a nervous public speaker to imagine a situation where she felt completely confident and physically comfortable. Once connected to this image, she might place thumb tip and index fingertips together. The process would be completed several times. Next time the speaker felt the anxiety, she would use the physical anchor to access the positive bodily state and counteract the nervous stress.

The Alexander technique F.M. Alexander was born in Tasmania in 1869, and became an actor, performing extensively around rural Australia. After his recovery from an illness, he found that he had a persistent hoarseness that became progressively worse during his reciting. An ENT specialist found nothing structurally wrong, but the problem continued. Alexander began what biographer Michael Bloch (2004) calls a ‘laborious process of self-observation with the aid of mirrors’. He noticed that in his reciting (and to a lesser extent in ordinary speech) he ‘tended to pull back the head, depress the larynx, and suck in breath through the mouth so as to produce a gasping sound’. In addition, he found that he was lifting his chest, shortening his stature and tensing muscles in his legs. He realised that it was difficult to train himself to do things differently, because each negative action connected to others, and was so habitual that it felt right and familiar.

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Alexander found that the solution lay in: • focusing on inhibiting, i.e. he put his attention on not doing what was wrong, rather than struggling to do what he felt was ‘right’ • using conscious control rather than unconscious habit • focusing his mind ‘on the means whereby, rather than the end to be gained’. He found that he cured both his voice problem and his long-standing respiratory problems. From his experiences he began to teach others about his core principle, that use affects function, and trained them in related techniques to facilitate the best possible use of the body. Bloch says that there are around 4000 registered Alexander teachers around the world. Many music and acting courses have a teacher on its staff, and most big cities will have teachers who offer one-to-one sessions. In the technique a trained teacher uses his hands to gently move a person’s limbs, head and spine into better coordination. Pupils experience new sensations and movement patterns in their day-to-day activities, and these can take over from the older negative habits. Rob Macdonald (1997) writes ‘the Alexander Technique is a process of bringing proprioception into consciousness in order to help remedy the problem of acquired misuse. Misuse occurs where our proprioceptive body model has been confused as a result of acquired habits of musculoskeletal constriction’.

Example 17.1 Personal story In my 20s I went to an Alexander technique teacher to see whether there might be help for my upper back pain. I arrived with a handheld briefcase and was impressed when the teacher immediately commented that she could tell that I usually carried a shoulder bag over my right shoulder. She saw that the right side of my upper back was habitually held in a raised and tense posture. As I lay on a firm couch, she gently moved my head and neck, together with my arms and legs, and took me through several sequences of movements to stand and sit, all the time guiding my body with her hands. I left feeling both longer and more relaxed. After several lessons, my back pain was gone. There was an added bonus in that my digestive problems improved; the regular use of the semisupine position allows the spinal column vertebrae to release their downward pressure on each other, and the long intestinal coils to do the same.

Although often considered as a method of achieving postural change, the Alexander technique has a wider reach. Glynn Macdonald (1994) describes it as a ‘way of learning how to change’, because it is ‘the means of achieving one’s purpose in relation to finding a better way of using oneself’. Wilfred Barlow (1973), pupil and then colleague of Alexander, emphasises that ‘the Alexander Technique is not a form of relaxation therapy’. The pupil will, however, ‘eventually be prepared to let go more deep seated and unconscious tension patterns’. Three important applications of the Alexander technique to voice work are the concepts of the body learning and body grammar, and the use of the semi-supine position for general release and breath work.

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The body learns Most Alexander technique teachers use a minimum of intellectual explanation. The student can ask questions, but the learning happens as the body does things. When we first learn to drive a gearshift car, we have to focus intently on the sequence of pushing down on the clutch, moving the gear lever into first gear, gently releasing the clutch and pressing the accelerator without stalling the car. Most drivers will have several jerky starts, and then suddenly we can move off smoothly each time, because the sequence of movement and tension settings has been learnt by our bodies. If we regularly use a re-discovered pattern of healthy head–neck alignment, or a different way of breathing, or a new tongue or jaw setting, after a while our body learns to function in this different way, and we no longer have to think about it. This relates directly to the ‘implicit memory’ discussed in Chapter 2.

Body grammar The Alexander teacher may encourage her pupil with relevant words, such as ‘neck free, head forward and out, back lengthen and widen, knee out of the hip, shoulder release and widen’. Barlow (1973) speaks of the use of ‘body grammar’ as pupils gradually start to use these terms as internal reminders of good use. Such key phrases can be used as personal reminders in voice work. A primary school teacher told me that, before the children arrive in the morning, he says out loud ‘drop shoulders, breath low, jaw release’ to imaginatively prepare his body for the day ahead. A busy accountant has on her computer screen a yellow square of paper, which simply says, ‘tongue release, jaw drop, throat open’ to encourage her to stop her pattern of regular channel clamping during concentrated writing.

Semi-supine position work Alexander technique teachers work with the use of their pupils’ bodies in any physical position required, whether walking, singing, horse riding or playing the bagpipes. However, most will do some early work with their pupil lying in the semi-supine position. (A full description and image of this posture is included in Chapter 18.) Acting students are well used to ‘floor work’ as part of their voice sessions, but many clients can benefit from specific work in this position on the floor or couch, for a number of reasons: • Sensation: it offers a client an opportunity to focus on body sensation and activity, leading to increased awareness of asymmetry or tension. • Release: it encourages the release of excess muscle tension, particularly if the voice practitioner ‘talks through’ a simple list of habitual tension places. • Alignment: it places the client in a position where spine, neck and head can be in alignment. • Shoulder release: the shoulders are able to fall back, rather than being hunched up, pushed forward or pulled back.

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• Upper back: the upper back spreads and widens, thus opening up the chest. The vertebrae release a little, lengthening the back. • Lower back: because the knees are bent up, the lower back is in contact with the floor or couch, so there is no back arching or stretch across the ribs or stomach, which might constrict the breathing. • Breath awareness: in this position gravity encourages the inward movement of the abdominal muscles during expiration, to which the client’s attention can be drawn. • Breath development: the light pressure and possible warmth of the client’s own hands on his abdomen give kinaesthetic feedback to encourage the placing of lower breathing. • Emotional support: it can offer an opportunity for the client to experience a sense of being physically held, which can lead to an emotional release. As we are no longer ‘eyeball to eyeball’, it may be easier for a client to talk about personal issues. Not for nothing is this the position of the traditional psychoanalyst’s therapy transaction! • Individual practice: it offers a period of simple ‘active undoing’, which the client can do regularly at home. This offers a neutral base before direct voice work starts and an opportunity for general energy restoration. I suggest semi-supine work only when relevant for a particular client’s needs, and there must be enough trust for him to feel comfortable enough to lie flat in the room as he is taken through a sequence. After the session, which is generally recorded, the suggestion is made that he takes 15–20 minutes to use the position at home several times during a week. He may use the recording as an instructional companion, choose to do it in silence or play a favourite peaceful music extract. As it is about body release, posture and alignment, he does not need to worry if his head is full of circling thoughts, though of course it is more relaxing if they cease for a while.

Voice story: David David was an internationally successful opera singer in his healthy mid-40s. During an engagement in the first week of a cold February, he developed laryngitis and was ill for 10 days. At the end of this time his voice was still husky, and ENT examination found ‘rhinosinusitis, prenodular laryngitis and reflux arytenoiditis’. This meant that he had inflamed and runny sinuses, swollen inflamed vocal folds, with particular swelling in the area where vocal nodules could develop, and red arytenoid cartilages as a result of reflux. David was prescribed prednisone (a steroid to shrink the swelling), a decongestant to clear his nose, an antacid to treat the reflux and total silence for 3 days. He came to see me in mid-March because, although all laryngeal pathology had gone and his vocal folds looked normal on ENT examination, his voice was still not working properly. He described it as being weak and ‘somehow soft’, and said ‘I feel as if I have to push it up the hill to get the notes and quality that I’m used to taking for granted’. As he was due to sing in Italy in 6 weeks time, he was very concerned. I was interested to hear that, for several months before the laryngitis, David had felt a serious ‘loss of consistency’, and that he ran out of power and the confidence that he could sustain a through line. As he was about to make a significant change in his reper-

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toire, this was of real concern to him, and had not been solved by returning for in-depth singing lessons before his illness. At our first meeting, I noticed that David’s sitting posture was very slumped, with his head sunk into his neck, legs stretched out, buttocks in contact with only the front part of the chair, and his back curved against the chair back. His breath pattern in speaking was shallow and upper chest and I was fascinated that he could only sustain a sustained sss for 12 seconds – greatly reduced for what would be expected for so experienced a singer. He still had excellent technique in his singing voice, but his conversational spoken voice was not well supported by his breath in everyday life, and he had noticeable creak and constriction towards the end of long sentences. He said that he rarely exercised as he felt that his singing and ‘running about on a stage in tight clothes’ stretched him physically, emotionally and mentally. I pointed out that, however energetic, the endgaining physical demands of a performance are not the same as exercise or bodywork. We discussed the relevance of posture and breath, and I gave David a 15-minute sequence of practical floor work to be done every day, with a specific focus on stretching, body lengthening and alignment, lower breath and channel deconstriction. In addition I gave him some very basic exercises to build up breath outflow in speech, and suggested that he saw an Alexander technique teacher colleague for some lessons, which he did. He rang me from La Scala 4 weeks later to say that his singing voice had recovered completely. He was now taking seriously his posture and body use in ordinary life, and told me triumphantly that he could now extend a sustained sss for 37 seconds ‘even when I’m deliberately slumping!’.

Martial arts Dreesen (1999) writes ‘I think the whole practice of martial arts is to let go of concern. Be here now for yourself, then there is a release mechanism and then that deep inner personal acceptance’. Miller (1986) describes the need for singers to acquire ‘centring’ which he says is ‘closely related to ancient exercises of both East and West that unite mental and physical responses (mind and body)’. Many Eastern traditions link personal strength and acceptance to a physical focus centre in the lower body. This is generally placed one and a half inches (or the three middle finger-widths) below the navel, and one and a half inches (4 cm) inward toward the spine. This point is called the hara in Japanese, or the dantian or tai-tien in Chinese medicine and martial arts. In these traditions it is considered to be the body’s physical centre of gravity, and the seat of a person’s internal energy – the ‘chi’ or ‘qi’. Buddhist teaching suggests that focusing our mind on this area in breathing, meditation or quiet attention allows us to access a deep calm, helping to control troubling thoughts and emotions. Even the popular press sometimes advocate its relevance. ‘According to Taoist wisdom, your belly, and particularly your lower belly, is the centre not only of your body but of your physical universe. . . . If you constantly keep a few degrees of awareness just below your navel your words and deeds will ring more true, you’ll feel mentally as well as physically more balanced, and your will to succeed in whatever you’re doing will increase’ (Arendt 2002).

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Those who work with these teachings do not offer simple advice and would say that serious work is needed to ensure healthy ‘chi’. They believe that the energy needs to flow around the body, and can be blocked by emotional holding and tension in the tan-tien area. One practice that is believed to enhance its flow is that of t’ai chi, a movement ritual that has been practised in China for 2000 years. Its slow moving practitioners can be seen in the open air in China, and increasingly in the urban parks of the western world. T’ai chi is a kind of meditation in motion. It has a strong spiritual tradition behind it and uses images, but it can be done as a straight physical practice. Deep breathing and relaxation are combined with postures that flow from one to another via slow movements designed to access energy and release negative feelings. American researchers from the Tufts-New England Medical Center in Boston reviewed 47 studies looking at the effect of t’ai chi on both healthy people and those with chronic conditions. Dr Chenchen Wang et al (2004) reported that: ‘overall these studies reported that long term T’ai Chi had favourable effects on the promotion of balance control, flexibility and cardiovascular fitness and reduced the risk of falls in the elderly. Benefit was also found for balance, strength and flexibility in older subjects and pain, stress and anxiety in healthy subjects.’ Other body disciplines from the eastern world, including Aikido, Qi Gong, Karate and the different schools of yoga provide deep body training, which can benefit the voice. Comins (2002) describes the strong sound of an Edinburgh choir who warm up with exercises based on yoga. Many voice practitioners have been influenced by such practices. The website of Fitzmaurice Voicework, widely used across the USA, describes how Catherine Fitzmaurice has been influenced by both the emotional and body work of Wilhelm Reich, and ‘body-based disciplines and energy work such as yoga, shiatsu, meditation and healing techniques’.

Voice story: George George was a musical theatre singer in his early 30s. This is an age when professional singers can rely far less on natural ability, and often need to use solidly based conscious technique for protection and survival though any demanding times. George had been misusing both his body and his voice for months and, after a heavy cold, had to have 3 weeks off work because his voice had not fully recovered. It was only because he was the valued and charismatic lead in a London West End show that management had not replaced him, but he was allowed to return only if he could prove himself in front of the musical director, company manager and manager of the theatre group. George had three voice therapy sessions and several with his singing teacher, and we all agreed that he was ready to go back into the show. He asked me if I would come along to the ‘re-audition’, which was taking place on the theatre’s vast stage. His singing teacher was also there and he took George through a vocal warm-up. All went well to start with but, a few minutes into a key song, George’s voice cracked on a particular high note. The musical director stopped him and he tried again, but still failed. George was desperate. ‘I can do it, I can,’ he said. ‘Just breathe,’ said his singing teacher, and George again strained ineffectually to reach the high note. The management shook their heads and looked very unhappy. I asked if we could have 2 minutes together in the

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wings. There I firmly rubbed his back and shoulders, had him jump up and down, shake through his whole body, and bend over from his waist, letting head and shoulders go loose, and sighing and groaning in that position. Then in an upright standing position I told him to rub hard, round and round in a clockwise direction, in a big circle over the diaphragm and lower abdominal area. I suggested that he picture an image of core stability and centred strength there, and breathe into that place. George returned to the stage. He was still very nervous but had released his generalised central body clenching and subsequently accessed a sense of deeper power and confidence. This time the song went well with no breaks or strains and he was allowed to reenter the show later that week. In the interim, we firmed up a quick release procedure for him to use several times daily until it felt part of his implicit memory. The new routine worked and he was able to maintain his lead role.

Free movement Infant school playgrounds are full of children running, jumping, skipping, stretching, rolling, dancing and turning somersaults. Often their speech is accompanied by illustrative movements. ‘It was a huge monster,’ says 5-year-old Moses, arms stretched out to demonstrate. ‘It tasted horrible, horrible!’ shrieks 4-year-old Ali, screwing up his face and whole body as he remembers; 5-year-old Rowena twirls round and round as she tells you about her new party outfit. ‘My dress is so, so pretty!’ As they go through the education system, children have to learn to sit still and not to move every time they feel like it. In social situations adults know that too much movement in body or voice needs to be inhibited, and some even feel slightly self-conscious if dancing in solitude to the radio in the kitchen. Free movement is just that – moving according to how you feel. It can take place in silence or with music, alone or in a group. American voice teacher Bonnie Raphael said that, while tension goes inwards, energy goes outwards (British Voice Association study day in London, UK in 2003); free movement can change negative muscle tension into positive energy tone, e.g. if tired and dispirited, stretching through the spine, rubbing the limbs and shaking through the whole body can give a new sense of energy. One client was a busy politician whose voice would often get very tired. Among our work was a simple physical sequence to loosen and enliven his often weary muscles. We agreed that, if members of parliament could occasionally have a 60 second ‘shake through’, we would be less likely to see television images of MPs slumped with lassitude and exhaustion. As a drama school voice teacher I recognised that appropriate free movement could help later voice work because it gave students the chance to: • • • • •

warm up and enliven the muscle tone of the whole body release habitual slumping, contractions, retractions and negative postures set up a need for deeper breath feel more connected to the body change an energy or mood.

Using pieces of music from around the world, the students would warm up by moving as they wanted. It was made clear that this was not about dancing and watching each other.

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The focus was on themselves, to increase awareness of what their bodies wanted to do, and work through any strain or resistance that they might feel. If their energy was low and exhausted, they could lie on the floor, identify how and where they felt the fatigue, and move as their tired bodies wanted. From observing their movements six particular words developed and led to a simple movement sequence. These are: Still Stretch Shake Swing Sway Lengthen

The sequence lasts about 8 minutes, and is an unthreatening basic movement template sequence for unknotting the body. Even working one to one in a clinical or business setting, clients can be taken through a shorter adapted sequence to loosen up before voice work. It can be done with deep imaginative attention or quite matter of factly! The field of Authentic Movement developed from the original approach of Mary Starks Whitehouse, whose work had its roots in dance, Jungian studies and pioneering work in dance/movement therapy. The website of the Authentic Movement Institute states that it offers the chance to explore ‘the inter-weaving of the creative, psychological and sacred’ through an approach in which ‘movement is the personality made visible’. Authentic Movement is ‘a completely self-directed form in which individuals may discover a movement pathway that offers a bridge between the conscious and the unconscious’.

Five rhythms dancing (5Rhythms™) A different but associated approach is that of Gabrielle Roth’s 5Rhythms movement practice. Roth is an American dancer and in her autobiography, Maps to Ecstasy (1999), she describes how she ‘discovered – in observing my own body and thousands of others – the five sacred rhythms that are the essence of the body in motion, the body alive’. The core rhythms are flowing, staccato, chaos, lyrical and stillness, but there are also others. Core to Roth’s work is that ‘the rhythms don’t just exist in the dance; they infuse every aspect of our lives’. By dancing them, we can access, express and move through these rhythms and their emotional relevance in our lives on our soul journey. The approach is taught only by certified teachers, who provide appropriate music from a huge number of sources for the different rhythms, and participants in a group session can then ‘discover their own expression of them’ in dance, or even in silence. However, a solitary dancer can put on one of Roth’s own CDs or other piece of music and move through the five rhythms in her own quiet living room. At the end there is usually a great sense of both release and strength; as Roth writes ‘The fastest way I’ve found to still the mind and be aware of the moment is to move the body’. Disabled or able-bodied, young or old, sad or happy, almost anyone can express his heart in movement or voice in some form or other. Eldridge Cleaver (1969) wrote in his cell in California’s Folsom State Prison ‘song and dance are perhaps only a little less old than man himself. It is with his music and dance, the re-creation through art of the rhythms suggested by and implicit in the tempo of his environment and his life, that man purges his soul of the tensions of daily strife, and maintains his harmony in the universe’.

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Voice story: Katarina Katarina had been a professional singer for 14 years but was almost entirely self-taught. Her repertoire was eclectic and included Celtic, African, Islamic and many other songs from varied cultures and eras. She had had a vocal haemorrhage 18 months previously but since that time all had been well. Then, 4 weeks before I saw her, she noticed that her voice often went ‘squeaky and tired’ in the middle of a song. This was not inevitable, but frequent and unpredictable enough to be unnerving. She was inevitably anxious because she was shortly to go on a world tour as a support act with a leading rock band. ENT examination found no abnormality of structure but definite signs of excess laryngeal constriction. As Katarina sat and talked to me, she fidgeted continually, jiggling her legs, shoulders and head, and I could feel significant muscle tension in her neck and shoulder muscles. Katarina talked about the significant emotional stress that she had experienced during the last year, and described how she often woke in the middle of the night, full of anxiety. The life stress was not going to go away, and she was seeing a counsellor to help find a way through it. We discussed the need to try to reduce her habitual physical tension levels. Katarina told me that she could not bear being still and quiet as her mind ‘always got in the way’. She did not like formal exercise, but loved dancing at parties. I told her about Gabrielle Roth’s work, and tentatively suggested that she might like to go to a class to see what it was like. She went to a local group, loved it, and started to go regularly. Most days she made time to dance at home, and as her body and voice loosened up, the episodes of voice break disappeared. At a time when much of her personal life was in flux and disarray and she could do nothing to solve this, Katarina began to feel a sense of freedom and control in her dancing. It helped to shift the unresolved emotional pain stored in her body, and she had a pleasurable and problem free tour.

Massage There are many different sorts of massage, but what they have in common is that the practitioner uses his hands (and sometimes elbows, arms or even knees and feet) on the skin and muscles of another person, to release tight muscles and realign bodies. Many find that massage is a relaxing experience, but doubt that there is a carry over into ordinary life; clinician Janina Casper (2007) comments on her personal experience of this observation. A good massage, however, can give an experience of release to tight muscles and cramped posture, which can then go into muscle memory. With even a few regular treatments, a client can begin to recognise her habitual tendencies, and realise that there is an option that she had not felt or considered before. Some workplaces now offer employees the opportunity to have a quick lunchtime massage, and the Association for Massage in Schools (AMIS) has introduced peer massage in some schools. Initial research results from the schools involved are positive, with accounts that the children are calmer, there is less bullying and schoolwork has improved. Nowadays all professionals have to be very careful if they touch clients, because there are clear legal issues of protection, and clumsy uneducated touch can do physical damage

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to a client. Although many clients might benefit from a good massage, there are frequently financial limitations on this. Some people really do not like being touched and any practitioner must always respect this. However, many voice and singing teachers use a few moments of direct hands-on work on students’ stiff neck and shoulders. SLTs may refer suitable clients to an osteopath, physiotherapist or chiropractor (see below) but some offer what is generally termed ‘manual therapy’. Mathieson (2001) clearly describes both her own manual therapy techniques in the neck and laryngeal area, and those of Aronson (1990). She has found these to be effective in reducing clients’ muscle discomfort and preparing muscles for voice exercises. Voice practitioners should always check the training and credentials of any masseur whom they recommend, because an irresponsible practitioner can do real physical damage.

Voice story: Tony A well-known television presenter was referred with muscle tension dysphonia. He walked stiffly into the room and described a long-term lower backache that even his osteopath could not completely cure. He also told me about his very high general stress level. I began work on his vocal use, but also talked about the management of his physical tension. I did some direct hands-on work on his shoulder and neck muscles, which slightly improved his throat discomfort, but also suggested that a good quality massage might help. He was shocked at the idea that he might be spotted going into what he called a ‘massage parlour’. I explained that there is a huge difference between a seedy massage establishment and a highly respectable trained remedial masseur. He agreed to a home visit from a practitioner from a very reputable source, and at our next meeting was beaming with satisfaction. ‘She’s changed my life,’ he said, ‘I didn’t know that it was possible to feel so light, I feel 10 years younger.’ So committed was he to the sessions that he bought a massage couch so that the masseur would not have to carry her own up the stairs of his London flat!

Physical therapy If a client seems to have any long-standing patterns of muscle tension that seem to be significant to the voice, we may want to suggest that he sees an osteopath, physiotherapist, chiropractor or other specialist in the field. If these skilled professionals have a special interest and expertise in voice they can sometimes be very effective in ‘emergency’ cases, where a performer has to sing or act in the imminent future. Specialist osteopath Jacob Lieberman (1998) gives detailed descriptions of his ‘hands-on’ work with voice problems. Together with his SLT colleague, Sara Harris, he has trained other voice practitioners in his methods. Physiotherapist Ed Blake describes his work with singers who have voice problems (in Rubin et al. 2004). Casper (2007) reports on the researched benefits of Nelson Roy’s specific touch techniques with certain voice problems.

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The story below gives some idea of the complex physical detail that may be relevant to voice. I am grateful to Jacob Lieberman for allowing me to reproduce the notes that he sent to me about this client.

Voice story: Graeme Graeme was a 21-year-old classical singing student who developed problems in his range and quality during the second year of his training. He had sung tenor since his voice broke and, although he had never had problems before, he told me that his new teacher was ‘pushing him hard’. ENT examination reported ‘larynx normal’. I felt that Graeme had considerable extrinsic laryngeal muscle problems and asked him to see Jacob Lieberman. This was the report. ‘My findings are similar to yours. High tension in body and laryngeal area. Right scapula was retracted causing extra drag on right clavicle and therefore sternocleidomastoid muscles and omohyoid. The laryngeal muscles appeared very tender, in particular thyrohyoid, and the range of movement of the thyrohyoid complex was reduced. These are typical patterns in hyperfunctional voice use. The cricothyroid joint was on the close side, locked in a high pitch position. The whole larynx was very backed, which made it difficult to palpate the posterior margins of the thyroid laminae. Posturally, Graeme has a posterior weight-bearing pattern, with a tendency to have low backache. During the course of releasing the tension his voice dropped really low, and I wonder if he is really a high baritone, rather than a tenor. He said that the baritone range is much more comfortable for him. I advised him to contact you to discuss all these issues, and to continue with your vocal techniques to keep the larynx area more relaxed.’

Other relevant bodywork practices There are clearly many other practices that attend to the ‘whole body’ and can play a role in developing or supporting the voice. Some voice practitioners train in these areas. Pilates work (developed by Joseph Pilates 1880–1967) is now available in many gyms and fitness centres; it offers a way to develop body awareness and a strong but easy physicality in ordinary life. The term ‘core stability’ comes from this approach and is relevant to voice work, with its awareness and control of the deep tranversus abdominis and pelvic floor muscles. Feldenkrais practitioners (originated by Moshé Feldenkrais 1904–1984) use words or hands to direct students through movement sequences. The practice is seen as a body– mind exploration designed to lead to improved functioning (health) as students become more aware and find improved use of their bodies. Some clients with voice problems report significant benefits from complementary medicine. As reported in Chapter 16 Yiu et al (2006) proved that acupuncture was effective in the treatment of voice disorders, and research continues in this and other areas such as homeopathy and reflexology.

Chapter 18

Body voice exercises

The free voice is based in a body that is as free as possible from habitual awkward postures and excess tension.

Postural awareness Body 1: To observe the general habitual posture of your client: watch and note Watch the client as he walks, sits and stands, ideally without him knowing that you are doing this. Note anything that appears to be a possible negative to your own specific work, e.g. in head–neck and shoulder–neck relationship, body symmetry, shape of back holding, leg/knee tension. The head–neck alignment may be particularly relevant, so note any tendency to: • slump – with head tipped backwards, neck collapsed and chin poked forward • poke the head forward when speaking • tuck the chin into his chest. With the advent of digital photography it is perfectly possible to take some instant photos of a client’s posture, to compare habitual with improved. The contrast can be seen immediately, as is the case with the young man in Figures 18.1–18.3, and any relevance to the laryngeal musculature and voice can be discussed.

Body 2: To observe one’s own posture: the naked scrutiny If you think that the client might be able to tolerate it, suggest that she might try standing alone and naked in front of a mirror, to look at side-ways and front-ways views of any postural tendency that you have discussed, and to see whether she notices anything else.

Voice Work: Art and Science in Changing Voices. Christina Shewell © 2009 Christina Shewell. ISBN: 978-0-470-01992-4

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Figure 18.1 Slumped sitting posture.

Although quite intimidating for many of us, the naked gaze can lead to new insights. I suggest it only to those whom I feel might be open to the idea!

Body 3: To become aware of the link between feeling and posture: imagining pleasant and unpleasant emotions Ask the client to stand by the door and close his eyes. Suggest that he imagines that he has just entered the room, and sees someone whom he likes and trusts. Direct his attention to the sensation in his body, posture and breath. He should then open his eyes, and return to normal. Then ask him to close his eyes again, and this time he imagines seeing someone he mistrusts and does not want to see. Again he should allow his body to respond to that image. After the exercise, discuss anything that he felt or you saw, and whether this relates

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Figure 18.2 Excess head extension posture.

to his body reactions in ordinary life. (In a group, emotions and sensations can be explored and discussed in pairs.)

Body 4: To become aware of the potential for lengthening through the spine: using your hands to encourage a sense of spine/neck lengthening in another person Check that the client has no specific neck or back problems, and don’t do this if he does. Ask him to sit, or to stand if you are taller than he is. Take a moment to encourage him to connect to slow lower breathing, and to imagine his energy dropping down to that place.

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Figure 18.3 Balanced sitting posture.

Gently spread your fingers and thumb out under his chin, supporting the base of the jaw bone itself, not pressing in on the soft tissue. Put the fingers and thumb of your other hand at the place where the head curves into the neck. Hold it carefully as the precious object that it is (Figure 18.4). Gently, very gently pull the head straight upwards in a very slight vertical stretch, as if pulling it a few centimetres away from the neck; it is important to make sure that you are not pulling the head forward or back. This usually gives clients the feeling of neck and spine lengthening, and for many it is a revelation about how much they retract or sink their heads into their necks.

Body 5: To feel a lengthening sensation through the spine: wall leaning Stand with your back to a wall, feet together about 12 inches (30 cm) away from the base of the wall. Let your head extend back against the wall, and lean back until your

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Figure 18.4 Hands on, lengthening upwards.

whole body is supported only by the back of the head. Keep the neck and back straight; stop at once if anything hurts. Stay in that position for 60 seconds or so, then put your weight first onto the back foot and then onto the front foot as you walk slowly away from the wall. Most people feel a sense of lengthening throughout the spine, as if they had grown taller, and in a group people often laugh and talk with surprise at the sensation.

Body 6: To feel spine, head and neck lengthening and alignment: balloons and carrots You can use images to help give a client an internal sense of lengthening upwards without strain or body contortion.

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Suggest to the client that he imagines a helium balloon is attached to a central point in the top of his head, and that its floating lifting power easily and smoothly lengthens his whole body from that place of contact, ‘coming up’ from the base of the spine. If you feel that a client needs to stay more ‘grounded’ than a balloon might encourage, use an image of a carrot. The feet are the roots, safely attached into the earth, the torso is the long, straight carrot, while the head and hair can be pictured as its green fronds, reaching upwards into the sun and air.

Body 7: To feel a sense of connection to the ground: feet, legs and ‘earth energy’ Ideally do this in bare feet, but certainly not in shoes. Stand in neutral and become aware of your feet. What do the soles feel? What surface is in contact with the foot? Picture your ankles, calves and thighs. Feel their connection up into the pelvis, abdomen, chest, spine, neck and head. Picture an energy flow that runs from the soles of your feet into the ground on which you stand. Imagine breathing in through the soles of your feet, drawing up nourishment from the earth itself. The breath comes up the front of the body, over the head and out down the back, into the ground again. The legs literally support us and a conscious awareness of their strength and flexibility, and that the ground in turn supports our legs, can help a nervous speaker access a new sense of power.

Floor work Body 8: For postural awareness, alignment and release of excess body tension: floor work in the semi-supine position ‘Floor work’ refers to exercises done with the body in contact with the floor rather than sitting or upright. The stability of the floor is always easily accessible, but a couch can be used with elderly or disabled clients and those who prefer it. Ask the client to lie on the floor or a firm couch. Put one or more books under his head, carefully checking that the height is right so that the head is neither tucked into the chest nor stretched back (Figure 18.5). Adjust the head rest if needed. The client’s feet should be flat on the ground (ideally with shoes off) with the knees pointing upwards, hip width apart. If he feels any strain in the thighs, the knees can lean in to touch each other. The upper arms lie parallel to the body supported by the floor, with bent elbows so that the hands can rest on the body. One rests just above the waist, and the other just below. If the person is rather large, the hands can simply rest where they are comfortable on the abdominal area or even on the sides of the body. The jaw is not clenched, and the tongue tip is deliberately placed behind the lower teeth, so preventing the tongue from falling back to constrict the throat. The lips may be slightly apart or closed.

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Figure 18.5 The semi-supine position.

As the client’s body begins to let go into this position, slowly talk through an awareness and release sequence; the words will be different every time but might go something like the sample below. Any release progression can be recorded as you talk it through with a client, and then used at home or away in a hotel room. The slow voice of a supportive voice practitioner can act as a guide as a client practises, and he knows that the words are specifically addressed to him.

Sample script for a semi-supine position sequence This 10 minutes offers a chance for awareness and a kind of ‘active undoing’ in your body use. This is time for you – there are no busy demands on you and nothing that needs doing except quiet attention and the occasional movement. Your legs are bent and knees are up to reduce the arching of your back, but if you become aware of any discomfort as we progress, feel free to stretch your legs flat, or make any other gentle movement. Sometimes people become aware of excess tension for the first time, before they find a way to ‘let go’. In this position certain things can happen that are less likely to happen when we are upright. The spine can lengthen, so become aware of its length, supported by the surface on which you lie. You have lots of vertebrae down the middle of your back. In this position gravity does not press them down on each other, so the spaces between them can release a little. Lift up your hips and bottom from the floor for a moment, and then slowly replace your back flat against the floor. See if you can get a sense of further release in the lower part of your back as you

278 Voice Work: Art and Science in Changing Voices picture it ‘sinking’ or ‘melting’ into the floor. As it does, the breath may go deeper into your body. Very slightly and very gently, rock your hips from side to side, feeling a sense of release in your lower back and hips. Picture your hip joints; don’t move your legs but imagine that your knees are slightly floating up and out away from your pelvis, as you release in that space between your legs. Send your attention to your shoulders. They can carry a lot of tension. Shrug them up towards your ears, hold tight for a moment . . . and then release. Then pull your shoulders down along the floor as if moving towards your waist. Hold for a moment. . . . Then release. Now push them back against the floor, pushing your chest up towards the ceiling . . . hold for a moment . . . then release. Get your shoulders as comfortable as possible, letting gravity drop them against the floor. Be aware of the weight of your head. The back of your head is resting on a support; take a moment to really feel that. Right now your neck muscles do not have to maintain the normal healthy tension that they need to keep your head upright, so they can release. Very slowly and gently let your head roll from one side to the other, and then back again. Do that again. Make sure that you are not clenching your jaw, and let your tongue feel floppy and heavy. Sense the weight of your head, and how it is supported. Find a central position for your head, sensing the length at the back of the neck. Focus on your hands as they lie warmly on your lower body. Notice whether they are moving. In this position, most people find that, as the breath comes in, they can feel an expansion in that lower chest and abdominal area. As the breath leaves, you will feel the body moving in as the lungs let go of much of their air. Just let this happen and notice it.

At some point I will usually then move into conscious and direct work on the breath in this position, before continuing practical work in a standing or sitting position. This is described in Chapter 19.

Body 9: To release the spine: floor work with lower legs resting on chair This position is a variation on the last, and can feel very releasing for a tired body. Lie on your back, head supported by low pillow or book, but place your lower legs on the side of an upright chair seat. With hands resting on the abdominal muscles, this is a good position to feel and develop lower breathing, and is generally helpful to whole body relaxing.

Body 10: To loosen arms and legs: the wobbly baby Lying on your back, lift your legs and arms upwards, keeping elbows and knees slightly bent and all limbs very loose. Shake them quickly and strongly, like a small baby kicking and arm waving. Enjoy the weight of the heavy wobbliness of your legs and arms, and the inelegance of the movements! This is a nice exercise to do in a group, to enliven people and prepare them to move upright, after a deep and quiet experience of floor work and sound making. It usually makes

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people laugh, particularly if you suggest that they can let any sound (including suitable ‘baby noises’) come out as they shake.

Body 11: To connect to the lowest part of the torso: rocking the pelvis and ‘sounding’ Lie in the semi-supine position. Imagine the breath going deep down into the pubic bone, the inner thigh and the hip sockets. Release any tension that you feel holding in those areas. Gently rock the base of your spine and pelvis back and forwards in tiny movements. Try to feel that the deepest pelvic muscles are making that movement. Then make very small circles with that same area, with the image of moving round a clock face. Keep it slow and sensuous, and take your time. Sigh out as you make those movements – feeling a deep release. You can then move into finding a sound that goes with the movements, exploring it and allowing both to develop in a voice–movement improvisation.

Body 12: To let go in the prone position: face flat Having done some semi-supine work, roll over onto your side and then over onto your front. As you roll over, try not to lift your head. Let the neck stay loose and floppy so that your head stays in contact with the floor. Turn your head sideways; you can have your arms bent up by your head and rest your head on your hands, or you can have your arms by your side and simply rest the side of your head on the floor – whichever is more comfortable. Feel the contact with the floor all the way along the front of your body. Focus on the sensation of the breath moving your lower back as it enters and leaves. Note that, whenever a person gets up from the semi-supine position, it is important how he moves to upright. If he pushes up on his arms and sits straight up, his shoulders and neck will have to tense – hence the roll-over. Some people feel supported and relaxed in the prone position, whereas others experience themselves as uncomfortable and defenceless. We can give the client the choice as to whether to stay prone for a few moments, or to move quickly through it into a ‘hands and knees’ (all fours) position. Tell them to take this very slowly and be aware that they may feel a little dizzy or light-headed. Once upright, stretch and shake to restore the muscle tone needed for action. After a dog gets up from a lying position, it will usually stretch – back legs first and then front, before shaking. So do your legs first and then your arms!

Body 13: To flex the spine: concave and convex Kneel on your hands and knees. Feel their contact with the floor, and make sure that you are comfortable. Spread your fingers and feel their contact with the floor. Arch your back

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up, chin tucked down onto your chest. Hold for a few moments. Then slowly bring your head up, look up and poke your chin up toward the ceiling. As you do this, let your back sink down and feel it become concave, with a middle back hollow. Very slowly alternate between the two positions, three or four times.

Body 14: To flex the spine: the cat and the dog On hands and knees, position yourself so that your back is as flat as possible. Arch your back upwards, imagining that you are a cat, and that someone is stroking and rubbing your back in the most delightful way. Move towards the imaginary hands. Now imagine that the hands leave you and you become a dog. Feel your hips move from side to side as you wag an imaginary tail with pleasure. Suddenly it begins to rain, and you shake throughout your body to try to get the wet drops off you. This exercise can be done in pairs, with one person actually rubbing the back of the other, so that the back movements can respond to real-life pressure.

Body 15: To stretch the spine: the ‘child’s position’ yoga stretch Kneel down, ‘sitting back’ on your folded legs. It is usually more comfortable if your knees are a little way apart from each other. Bend your body over towards the ground, head coming near or even touching the floor. Stretch your arms forward, and place your hands flat on the floor as far in front of your head as you can manage without discomfort. Rest there for a minute or so, feeling the stretch through your spine. Feel the breath coming into your lower back area. With flexible clients with no back problems, this exercise can be part of the sequence as they move from the semi-supine into the upright position.

Upright work: still or moving Body 16: To feel a sense of solidity: neutral or centred standing In bare feet (or at least with no shoes) stand with feet parallel, roughly hip width apart, so that your legs feel as if they are in a line with your hips. Have your arms hanging loosely by your sides. Let your weight feel as if it is placed slightly more on the front of your feet than the back. Don’t lock or bend your knees, but have a sense that you could bend them if you wanted to do so. Feel a lengthening up throughout the whole spine, starting with its base and moving upwards along its length. Rock your pelvis backwards and forwards for a moment until you find a central position with your buttocks very slightly ‘tucked in’. Make sure that you do not arch your back by thrusting your abdomen or pelvis forwards. (If you know how to do so, gently constrict that deep abdominal ‘core stability’ muscle,

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transversus abdominis.) Make sure that your back is not arching or your chest pushed forward. Don’t round your shoulders; they should be loosely dropped, not raised or pulled forwards or backwards. Move them around until you can feel that balanced position. Let your head nod gently, imagining a kind of fulcrum on the top of your neck, until you have the sense that it is comfortably balanced, with the chin very slightly tucked in so that you feel a lengthening at the back of your neck. Picture the centre of the top of your head; imagine a light beam shining down on this and lengthen up towards that light. (Some people like the image of a string from that place, pulling them up.) At the same time, be aware of your feet and their connection to the ground; you have balance of the levity and gravity energies. Keep breathing and become aware of your body in this posture. You are deeply still, but alert and ready for action. There are many varieties of instructions on how to achieve this neutral balanced posture. Whichever way you use, this gives a good feeling of postural stability.

Body 17: To loosen the shoulders: shrugging, circling and shaking Stand in the neutral position or sit with your back in contact with a chair back, with head and neck well aligned. Let your arms hang loosely by your sides or rest in your lap if sitting. Shrug your shoulders up towards your ears and hold tightly for a slow count of 1, 2, 3, 4, 5. Drop the shoulders, register the sense of release – and then repeat the sequence twice more. Circle the shoulders slowly backwards, letting them come up towards the ears, and then back towards the shoulder blades, down towards the waist and round to the front. Repeat three times. Then circle them the other way three times. Stretch your arms above your head for a moment – feel the lengthening through your spine. Shake your hands, your forearms and then your whole arms – in front and then to the sides of your body. If there are no neck, shoulder or back problems these loosening exercises can be helpful for those who spend many long hours sitting in one position at work, or those whose movements are limited by age or infirmity.

Body 18: To loosen shoulders: forward arm swings Stand in neutral. Make sure that your legs are solid and your feet are parallel, hip width apart and pointing forward. Take time to focus on the feeling of your feet contacting the floor. Slightly bend your knees and swing your right arm forward as your left arm swings back, then reverse and get a rhythm going. Do not rush it; really feel the weight and momentum of that movement, and the movement in your shoulders. As you continue to do this let your knees be soft enough that your legs flex a little in time with the arm movements. Imagine that the momentum of the arms is influenced by their own weight, rather than your deliberate muscle energy.

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You can match a conscious in-breath and out-breath to the movements, or add a simple sound, e.g. a hey, each time one arm comes forward, with the breath entering as the other arm comes forward. Shoulders are not constricting yokes holding oxen heads, but the saucer that balances and steadies the cup for ease of movement and transfer. (Rodenburg 1992).

Body 19: To loosen shoulders and spine: swinging arms round torso Stand in neutral, arms hanging heavily by your sides. Let your arms begin to swing around your body, first one arm in front of your body with the other behind, and then the reverse pattern. Allow your shoulders to move but do not yet twist your torso or move your neck. Let the momentum build until you are letting the arms fling around your body. Observe your breath pattern. After a minute or so, let your whole upper body begin to move following the arms, so you will turn from the waist, to one side and then the other, letting the head follow round as well, but not tipping it back- or forwards. Let the breath come in one side, and blow out on a strong fff on the other side. Continue for about 2 minutes. Jacob Lieberman, specialist osteopath and psychotherapist, recommends this exercise as being good for loosening the shoulder girdle, thoracic spine and ribcage (personal communication, 2006).

Body 20: To loosen the spine: the drop-over Stand comfortably in the neutral position and let your chin drop onto your chest. Wait, and feel the stretch in the back of your neck. Imagine that your head becomes heavier and heavier, and let it slowly begin to move forward and down towards the ground. As it moves down, your spine begins to curve over. Let your shoulders move forwards and your arms hang heavy and loose. Continue on down just so far as feels comfortable – never force it. Stay there for around 20–30 seconds, or until you want to come up. Have an awareness of breathing into the lower part of the back. Very slowly, uncurl upwards, picturing the spine unraveling from the base, as if building vertebra by vertebra until you are upright. This is a classic voice/movement exercise. Some actors use it as a quick shake-out tension release in the wings, before they go onto stage. It is also good for any stressed voice practitioner between client sessions!

Body 21: To loosen spine and neck: drop over with silky hair advert In the drop-over position, let the head and shoulders move gently from one side to another. Even if you have short hair (or even none at all), imagine that you are showing off your clean and shining hair in a television advertisement. Be aware of your neck, and do not hold it rigid as the head swings gently from side to side, releasing any neck tension.

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Body 22: To loosen spine and neck: in the power shower If you have strong power jet of water from your showerhead, try dropping over from the waist, letting your arms hang loose and position the jet of water to pummel the base of your spine. Uncurl slowly, letting the water massage up the vertebrae as you come up into a standing position, and then let the jet of water massage any excess tension in your shoulders.

Body 23: To loosen the spine: uncurling the spine against another’s hands Ask the client to let himself drop over as far as is comfortable, and to hang in that position for a moment. Place your hands at the base of his spine, and as he slowly uncurls, let your hands move up the vertebrae, pressing gently so he has some sensory feedback to help him feel the different areas uncurling (Figure 18.6). This is good to do in pairs in a group.

Body 24: To loosen and warm-up the body: limb shake Shake one hand, then move up the forearm, and on into the whole arm – start gently and then work up to a strong shake as if your arm wanted to get away from your shoulder.

Figure 18.6 Uncurling the spine against another’s hands.

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Then do the other arm. Then one leg and then the other leg. Then shake through your whole body, moving up and then down. It is fun for a group to let sound come out as they shake their limbs.

Body 25: To loosen the body in activity: core movement words With or without music, take a client or a group through a simple movement sequence around words and movements designed to allow a process of ‘unravelling’, or ‘enlivening’. I use the sequence: Still Stretch Shake Swing Sway Lengthen

In group work, I sometimes start with people lying in a curled up and restricted body position, gradually working through the sequence and ending with vigorous ‘round the room’ movement. You can of course use other words, such as ‘Curl up, Stretch, Shiver, Shake, Run, Jump’ for energy work with younger clients.

Body 26: To feel a sense of grounding: t’ai chi slow walking The essence of this exercise is to do it so slowly that you have time to register each tiny adjustment that the body makes in moving. Imagine that you are living out a slow motion film. This is best learnt with a t’ai chi teacher. Stand in neutral. Throughout this movement, let your arms hang loosely by your sides, keep your back long and head up, looking forward. Very slowly, allow your body weight to move over into your left side, and at the same time, very slowly, lift your right foot and let your leg swing slowly forward and out, until you feel it is the right place for you to be able to step easily onto it. Slowly place your right heel down on the floor, and bit by bit place the rest of your whole foot onto the floor, until the sole is firmly grounded. As that is happening, the rest of your body will have been moving slowly forward, and the weight moving from left to right. When you feel that the weight is now resting on your right leg, repeat this slow movement with your left leg. Move around the room in this very slow way, keeping your awareness intensely focused on the feelings in your body and breath as you do so.

Stretches Stretching is important in voice work, and can be used in some form with almost any client, regardless of ability or disability. Each of my group sessions with those who have had strokes or Parkinson’s disease used to start with gentle stretches and bodywork. The principle of a stretch is that maximum active muscle extension will be followed by an equivalent release. The instruction to ‘reach’ may not achieve the same as ‘stretch’; an extended limb

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may not be stretched. There are a multitude of different stretching exercises; these are just a few of them.

Body 27: To stretch the neck: turning and tipping the head Make sure that the shoulders are dropped and not hunched or held tightly. Keep the body facing forwards in the neutral position, and do not twist or bend the torso during this exercise. Turn your head towards your right shoulder and feel the pull on the left side of your neck. Hold for around 10 seconds. Then turn your head towards your left shoulder and feel the pull on the right side of your neck. Hold for around 10 seconds. Repeat that sequence, this time tipping your chin towards your shoulder as you turn the head. Tuck your chin in towards your chest, as far as it will go, and feel the pull at the back of your neck. Now bring your head upright and, lengthening up from your lower back as you do so, keeping the shoulders low, tip your head backwards until you can look up at the ceiling. Fell the pull at the front of your neck. Nod your head in big movements, forward and back. Keep back and shoulders still. Then move your head from side to side, as if shaking your head vehemently, using big turning movements. Now see if you can do a kind of ‘figure-of-eight movement’ with your head (a movement frequently seen all over India), gently moving it in very small adjustments, from side to side and up and down at the same time. I prefer these neck exercises to the action of rolling the head round and round, because the latter can put an undue and unnatural strain on the head–neck joint.

Body 28: To stretch the arms and torso, and lift the ribcage: arms out and arms up This can be done in a sitting or standing position. Stretch your arms out at right angles to the side of your body so that they make a T shape. The palms of your hands should face the ceiling. Drop your shoulders. Feel the stretch across your upper chest, and a sense of openness across the body, and possibly even in your feelings. Slowly bring your arms up until they are parallel above your head, with as little effort as possible – the image should be that they almost float upwards. Bring the palms of your hands gently together. Feel the stretch throughout your body. Don’t hold your breath. Let your shoulders drop if hunched up, and let your lower back release downwards if you are arching it. Slowly move your arms back down to the T position, at the same time blowing all the air out of you on a steady fff sound. Repeat several times. There are lots of variations on the practice of coordinating arm movements with breath, and you can develop your own sequences. As with all bodywork, the position of open arms and chest can have emotional effects; some people access a sense of enjoyable strength, whereas, for others, it feels painfully vulnerable.

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Body 29: To stretch the arms and torso, and lift the ribcage: arms behind the head This is a brief version of the one above, often advised for clients who spend many hours at their desks, because it is quick and ‘socially appropriate’! Lean away from your desk, letting your back rest against the chair back. Stretch your arms out to the side in a wide T shape, and then clasp you hands behind your head, resting your head against them. Your elbows will be bent; gently pull them backwards so you feel a stretch across the front of your chest. Feel how your ribcage opens and focus your breath so that it further expands them, on your abdominal area. At the same time, have a sense of lengthening from your lower back; you can arch it inwards for a moment, but then imagine a string from the top of your head, pulling you straight up and long. Hold and enjoy the stretch.

Body 30: To create a feeling of lengthening through the body: total body stretch Stand with feet hip width apart. Move your arms out into the T shape and then bring them up to stretch above your head. Reach up to the ceiling or to the stars (whichever image is appropriate). Keep your head looking forward, not up. Strongly stretch your arms and hands, and come up onto tiptoes. Feel as if the whole body is rising upwards, reaching and stretching. Feel the openness of your body. Hold for a moment and then release down to ordinary standing.

Sitting In voice work, many SLTs work primarily with their clients in a sitting position. Whenever physically possible, voice therapy exercises should always take place in standing and walking positions as well; we do talk when moving around.

Body 31: To use a healthy position in sitting: suggestions for a foundation posture Show the client some simple line drawings of sitting postures (as shown in Chapter 7). Ask her whether she recognises one or more as being habitual in her own body use, and discuss with relevance to her voice. You can both imitate them all, and this may lead to a useful awareness of options and possible changes. Understanding and motivation are crucial for change, because, even if it is not the healthiest, a habitual sitting posture may initially feel more comfortable than a new and healthier one.

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Body 32: To choose a suitable chair for long term sitting: chair choice Be prepared to talk with a client about their long-term seating in a work situation. Eight hours of poor posture each day may be a contributor to a voice or musculoskeletal problem. Contemporary seating may have a low back and, in these chairs, we need at least some tension in our neck muscles to hold up our heads. The backs of many chairs typically found in educational institutions and hospitals have a concave curve or an actual gap at the base; this will inevitably have a negative effect on a sitter’s posture. Thurman and Welch (2000) point out that when sitting, the tendency may be for the base of the pelvis to tip forwards and its top to rotate backwards. The lower lumbar spine will extend backwards into the space at the base of the chair back, because the shoulders and upper back will slump. Then the abdominal contents will be pushed upwards and restrict efficient breathing. The sitter will inevitably use extra contraction in his neck, back, pelvic and abdominal muscles to try to keep his torso upright, and his head and neck in good alignment. This places more pressure on the upper spine and neck, so that the larynx muscles work harder. A downwardsloping seat pad improves posture in a flat chair seat. If the back of this pad is higher than the front, the upper legs will slope downwards and the pelvis and spine ‘will align themselves very near to their upright standing position’.

Body 33: To support the head in voice work: the high-backed seat In voice work with clients who have excess neck or laryngeal muscle tension, the use of a chair with a high back to support their heads is recommended. This can help a new awareness that it is possible to ‘let go’ of excess tension in the neck muscles, which are intimately connected to those around the larynx.

Tension awareness and release Body 34: To illustrate excess muscle tension: writing and drawing with different tension settings Ask the client to write his name with three different tension settings in his hand – overtight, over-loose and balanced. (A child can be asked to draw a simple line picture.) This is a simple way to ‘tune in’ to tension settings as relevant for many muscles in the body, including those that work the voice. Remind the client that for the free voice we need a balanced tension.

Body 35: To demonstrate the effects of excess body tension on the voice: arm tensing Clench your fist, bend your elbow in until your forearm is touching your upper arm, stiffen that arm to the maximum tension, and the muscles of your hand, arm and shoulders will

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be tight and contracted. But you may also feel increased tension in other parts of your body, and may notice that your breath may become held and shallow. Keep the tension tight and intone a long aah sound, and count out loud, 1 to 10. Listen to the sound of your voice, then release the tension and repeat the intoned aah and the counting. See if there are differences in the sound.

Body 36: To identify and explore the effect of tension on the voice: negative practice Sometimes it is useful to point out body areas where a client tends to use excess tension, by asking her to deliberately over-tighten those muscles as she voices. (In voice therapy this is called ‘negative practice’.) Conscious active tension gives increased control over muscle tension.

Body 37: To tune in to the general tension in the body: visualise, breathe and release This exercise can be done in the semi-supine position on the floor, in a comfortable highbacked chair or use a low-backed chair placed against a wall, so that the client’s head is supported as it rests against it. His lower back needs to be in contact with the back of the chair, with the ‘sitting bones’ (the American ‘buns’) in contact with the back of the chair seat, legs uncrossed and hands resting in her lap. Ask him to close his eyes and breathe quietly and easily. Take him through a slow sequence of awareness. As you name different body parts one by one, he simply notices how each one feels, and moves or internally releases any excess tension that he may feel. The following is a sample list, from which you can select what seems right for a particular person: the back of your head, your head and neck, eyes, face, jaw joint, tongue, shoulders, right upper arm, right lower arm, right hand, left upper arm, left lower arm, left hand, upper back, chest, stomach, lower back, the length of your spine from its base to the back of your neck, hip joints, right upper leg, right lower leg, right foot, left upper leg, left lower leg, left foot. You can work from top to bottom, or bottom to top. Sometimes I feel that one client might need to be ‘lifted’ in his energy, so will move from head to feet. With others, I have the sense that they need ‘grounding’ and the awarenes moves from top to toe. A group class can be taken through this sequence, but take it slowly, because it is important to allow time for each person to tune into each place in the body.

Body 38: To tune in to the general tension in the body: visualise, breathe and release, with colour images This sequence is a variation of the previous one, used if a client or group is likely to respond well to visualisation.

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Once the client is comfortably settled, with eyes closed and hands resting on her abdominal area, focus her attention on the feeling of the breath entering and leaving under her hands. Ask her to imagine that the air that she is breathing has a colour. She can choose any colour that comes to mind, and indeed it may change. Make clear that this is warmly coloured healthy air. If no colour comes to mind, she should just imagine that the air brings with it a feeling of comfort and wellbeing. When it appears that she has a calm rhythm of breathing, ask the client to picture breathing that colour into each body part that you will name. As the breath leaves the body each time, the colour takes with it any negative tension that is held in that place, leaving a sensation of health and lightness. There is no need to ask a client what colour comes to mind but sometimes people will want to tell you. Some healers believe that we unconsciously choose the colours that we need – bright high-energy colours if fatigued, and soothing soft colours if anxious or distressed. Visualisations are a kind of gentle self-hypnosis and, as described in Chapter 2, neuroscience research suggests that the imagination can have physiological effects. A client can picture an image of a place where he feels safe and relaxed. This is often better than giving him one of your own, because we cannot know what setting has reassuring connotations for a client. I once planted the idea that a tense teacher might use the image of lying by a gently lapping sea, and she told me later that the relaxation had made her feel slightly queasy, as she had been desperately seasick on a cruise!

Body 39: To tense and then release different muscle groups in turn: progressive muscle relaxation Some clients like the sense of doing an active structured sequence, and the contrasts can give new insights into habitual tension patterns. Ask the client to lie or sit in a comfortable position. Tell him that you will take him though a sequence of attention and actions, where he will consciously and strongly tense various muscle groups for 7–10 seconds, and then quickly release that tension. Make it clear that the aim is for the named muscles only to tighten, and all others should remain as relaxed as possible. Give the instruction and say ‘hold – 2, 3, 4, 5, 6, 7, 8, 9, 10 – release’. Although at first you count those seconds out loud, clients quickly get the feel of the length of time that they need to hold the tension. After each release, stay silent for the client to experience that release in stillness for a few seconds, to notice how the muscle group then feels. He might even use a positive affirmation, out loud or in his head, such as ‘I am letting go of tension’, but establish this before you start the sequence. Then you move on to the next area. This is a sample sequence of muscle group actions: 1. 2. 3. 4. 5. 6.

Clench your fists. Tighten your arms as you fold your forearms up towards your shoulders. Hold your arms out straight, lock your elbows and tighten. Frown hard and screw up your eyes and nose. Clench your jaw. Shrug your shoulders up to your ears.

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7. 8. 9. 10. 11. 12.

Push your shoulder blades back as if you were going to touch them together. Take a deep breath and deliberately tighten your chest as you hold it. Pull in your stomach muscles and hold them tightly. Tighten your buttocks by pulling them together. Point your toes, extend your legs and tighten all the way down your leg muscles. Curl your toes in towards the soles of your feet, and tighten.

At the end, ask the client to quickly send his attention to each part of his body from head to feet, checking how each feels. If he identifies any tension, he should deliberately tighten, hold for 10 seconds and then release. The sequence can end with a less active image of well-being and comfort spreading like a warm blanket up through his body from toes up to head.

Body language: eye contact in presentation skills Chapter 7 described the importance of body language and I conclude with some examples of eye contact exercises, as one core aspect of body language. Even though the rules for one-to-one interactions vary hugely between cultures and genders, making eye contact with a group is generally a very important feature of public speaking in the English language, and it presents a challenge to many people. Quotes can reassure speakers that initial fear is natural. ‘The professional lecturer takes some time to train himself to look directly at the members of his audience, instead of over their heads, down at the rostrum or out towards the side or the back of the hall. Even though he is in such a dominant position, there are so many of them, all staring (from the safety of their seats) that he experiences a basic and initially uncontrollable fear of them. Only after practice can he overcome this’ (Morris 1967). And the more positive view ‘If you lift your head above the crowd, you must expect people to stare at it’ (Mitchell 1977). Few of us maintain eye contact with an individual or group for 100% of the time that we are talking, and it is quite appropriate to sometimes look away into space or at one’s notes. What needs to be avoided is a continual avoidance of meeting anyone’s eyes, a tendency to stay on one side of the room, or a fixation of the gaze onto one or two unfortunate listeners, for whom the sensation can be that of being trapped in a car’s headlights. Some shy speakers, and some from particular cultural groups, may need help with eye contact when speaking one to one, but this is less usual. The exercises below are all designed to be used in a group; all members experience both the exercise and being an audience member, and there is learning from both.

Eye contact 1: To improve eye contact: going round the group This is a simple confidence builder, which leads into speaking practice. Each person in turn walks slowly to the front of the room and stands to look at each member in turn, moving from left to right or right to left. As she does this, she counts out loud (to a total of however many people there are in the group), giving each person a

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different number. She must look at each person’s eyes, and the group will stop her if they feel that her eyes are skimming over the top of their heads. Having done this in linear order (i.e. each person in turn round the group) she then repeats the counting, but this time allocates the numbers randomly to each person so that her eye contact is moving. She then repeats this, using the days of the week, and then the months of the year. Then she speaks a set text, along the lines of ‘Good morning, my name is X, and I’m here to talk about Y’. Each word is given to a different speaker and, though this is clearly artificial, it continues the experience of maintaining eye contact. Finally the speaker says the first 2 or 3 minutes of her presentation, consciously and deliberately keeping that eye contact moving round, so that everyone is included. It will at first feel very unnatural, so it is repeated several times – until it is at least almost enjoyable!

Eye contact 2: Speaking to a large group: the division into six General advice given to a speaker with a large group is to regularly look around the room at different places. In practice many nervous or novice speakers tend to focus too much on one side or area of an audience. I offer a simple suggestion that the speaker quickly and mentally divides the audience into six groups, and talk to them as if he were talking to six people sitting in this formation (Figure 18.7). Just as a speaker should never neglect any individuals sitting at the side of a small group, so, in this practice, each group must be equally ‘looked upon’. Obviously the numbers can be added to if there are extra side galleries or other arrangements.

Eye contact 3: The light behind the eyes Public speakers often ask if they should smile at the audience. My usual answer is ‘only if it’s a real smile’. A forced smile can look insincere at best and like a grimace at worst. I suggest ‘the light behind the eyes’, and talk about this, demonstrating the difference in my own look with ‘empty’ eyes and ‘interested’ eyes. We all explore doing this.

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Figure 18.7 Eye contact with a large audience.

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Then each participant in turn stands in front of the group, with their eyes and face as ‘dead pan’ as possible. I ask them to count out loud, 1 to 20, going along the row(s) of listeners and speaking a different number to each group member. At some point during those numbers they should imagine turning on an ‘interest light’ behind their eyes, trying not to change any other aspect of their face at the same time, e.g. no lip movement. At the end of the counting the group try to ascertain when that light was turned on. If it’s not clear, the speaker has another go.

Chapter 19

Breath voice exercises

The free voice is powered by breath that flows from low in the body, and can support a variety of physical and vocal activities.

Breath awareness and placing Breath 1: To ensure connection to sensation and movement: loosen the clothes Loosen tight clothes before body or breathing work. It sounds very obvious but, if a client has a tight constricting belt or clothing, lower breath expansion can be restricted. Actors often experience this when squeezed into tight corsets. One classical Chinese theatre exercise required the actor to tie a broad sash tightly round his waist to act as a base for voice. This biofeedback method would not be advised because it restricts natural movements. Most breathing exercises in this section focus on abdominal muscle movement as breath support. However, if a client has more natural rib expansion as he breathes, work with this – at least at first. I tend to say that we are simply working to get active involvement of muscles below upper chest level (i.e. under the nipple line, but there is rarely a need to be so explicit). This may be felt as predominantly abdominal movement or predominantly rib movement, and both are fine.

Breath 2: Awareness of breath: sitting still and quiet in silence With eyes closed, simply sit or lie with hands resting somewhere in contact with your body. Take a few moments to become aware that you are comfortably held by the surface on which you rest, that this is time for you, to be still and do nothing. All you need to do is become aware of your breathing. As the breath enters you, picture the silent word ‘in’ within your mind, and as it leaves let this become the internal word ‘out’. Repeat and repeat. If

Voice Work: Art and Science in Changing Voices. Christina Shewell © 2009 Christina Shewell. ISBN: 978-0-470-01992-4

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other thoughts come into your mind – and they invariably will – just let them pass, and return to those thought images of ‘in’ and ‘out’. Do this for as long or short a time as feels right to you. Mindfulness of breathing is a meditation exercise, and can create a great feeling of stillness in mind and body.

Breath 3: To open the channel to breath: smelling the flower and drinking air Imagine smelling a flower; let the breath enter your body slowly and deeply without effort. Lift your hand to your mouth and pretend that you are drinking a glass of water; release the jaw and feel the sensation of your throat opening and the soft palate lifting. ‘Drink in’ the air, and feel it cool at the back of your mouth as it moves deep into your body. These two exercises are adapted from Miller (1986), who writes that ‘almost any vocalise (singing exercise) is a breath management exercise’.

Breath 4: Awareness of breath placing options: isolating abdominal, ribs and back areas Every voice practitioner should be able to consciously isolate and vary the place where the lower breath is focused i.e. whether movement is felt in the ribs, abdominal area or lower back. Of course all three areas work together, but the exercise is to increase awareness of each. Singers and actors should be able to work all these three areas in breath exercises, because those movements will then be available to them in performance when needed. The semi-supine position is a good position in which to start, but the sequence can be done in any position and, as in all breath work, should include sitting, standing and walking explorations. Use your own hands on each place in turn, because they give excellent instant biofeedback: 1. Just notice where you feel a movement rise and fall as you breathe. Place your hands on that area. If this is placed high in your chest, see if you can let the breath move ‘lower’ in the body. You may notice that, as you breathe out, the stomach seems to move in a little and, as you breathe in, there is a sense of expansion. After a few breaths, gently increase the movement of the abdominal (lower stomach) muscles as the breath leaves; gently pull them in, as if there was a string deep in the centre of your body that brings them in towards your back. Let the breath leave you through a slightly open mouth on a quiet fff sound. At the end of this sound, just release those stomach muscles and the breath will ‘drop’ back in. Do this about 10 times, each time tuning into that lower breath placing. 2. Now slide one hand round to your ribs at the side of your body, just above your waistband. Keep the breathing going and see whether you can feel the ribs moving. They may move up and outwards as the breath comes in. If not, see if you can deliberately move

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them inwards as you blow out, and then lift them sideways as the breath comes in. Do this around 10 times. 3. Leave one hand resting on those side ribs, and slip the other one in under your lower back. If lying, have the palm of your hand on the floor and its back in contact with the area at the bottom of your back of your ribs. Focus on seeing whether you can feel the breath expand that back area of the lower ribs – 10 times.

Breath 5: Awareness: lying in bed In bed, take a few moments to lie flat on your back, with your hands on your abdominal area, just noticing your breathing as you begin to relax into the surface of the bed. You will probably find that, under your hands, your body will be expanding as the breath comes in and gently contracting as the breath goes out.

Breath 6: Awareness: in water This exercise is generally enjoyed by children, and is a good way to tune them into the effects of breath on their bodies. Obviously young children should be supervised around water of any kind. If you like to swim or lie in the bath, take a few moments to try an experiment. Keep your face above the water so that you can breathe. Let yourself float in the pool; if in the bath, lie back with as much of your body under the water as possible. If you blow all the air out of your body, you will observe that your torso sinks down into the water. Let the breath come back into your body, and it will float back up.

Breath 7: Awareness: using the ribs Place the balls of your hands on the sides of your body, and your fingers pointing inwards towards the middle of your chest. Blow all the air out of you on a strong fff, using your abdominal muscle control if you want, but at the same time pushing firmly inwards with your hands like a corset. Make sure that your head and back are straight and well aligned. Keep the hands tightly compressing the side of your chest, wait for a quick 1, 2, 3 count, and then quickly let the hand pressure off, seeing if you can let the incoming air push the ribs out and sideways.

Breath 8: Awareness of rib movement: exploring rib reserve breathing (See Chapter 8 for comments on rib reserve breathing.) Have one hand on your ribs at the side of your body, and one hand on your abdominal muscles. Feel both those areas move in as you blow a long stream of air out of your body,

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until you have no more to blow. Let the breath come in, feeling the ribs expand sideways. Now see if you can keep them held out as you pant gently by using your abdominal muscles. Check that your shoulders are as dropped and released as possible. Now use those abdominal muscles to push puffs of air out: ff ff ff sh sh sh. Then use voice: mm mm mm, huh huh huh. Then count out loud, one lower breath pulse for each number – 1 2 3 4 5 6 7 8 9 10. Check that your ribs are still held out, and then speak a nursery rhyme or a few sentences. Then blow all the air out again, letting your ribs move in and return to your normal breathing pattern.

Breath 9: Awareness of the back: stand and curve over (An exercise first learnt from Patsy Rodenburg’s voice classes in 1985.) Stand with arms crossed in front of your body, elbows bent and the palm of each hand curved round the opposite shoulder, or on your back. It’s like a self-hug. Bend forward from the waist as far as is comfortable, and focus your attention on a sensation of breathing into the lower back. Movements of the ribs and stomach are slightly restricted, and focus the breath into the lower back. Feel the lower ribs moving outwards.

Breath 10: Awareness of central control: holding the breath from the centre Let the breath enter your body and, when you feel that you are comfortably full of air, for a few seconds do not let any air flow out. You are ‘holding your breath’ but do not do this by closing your lips or vocal folds. Try to feel that the central breathing muscles are ‘held in stillness’, not allowing the diaphragm to rise. (You can check for that control by blowing out a tiny puff of air on fff – if this is possible, your folds are open.) Then let the breath fully move out as the abdominal muscles move inwards, and the diaphragm relaxes upwards.

Breath 11: Awareness: the sides of the container Speech and language therapists often use the analogy of a balloon for the inside of the chest, and teachers speak of the container that can move in different dimensions in response to air intake. Houseman (2002) uses the image of a diamond and Linklater (2006) uses a box as breath container. Picture the inside of your chest as a box. The top of the box is your upper chest. Place your fingers on your breastbone in the centre of your chest, say a strong shh or pfft, and you may feel a little movement outwards. The sides of the box are your ribs. Place your hands on the sides of your body, feel the bony curve of your ribs and be conscious of them moving inwards and outwards as your

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breath goes out and in. Use a bit of deliberate action to move the ribs a little more as you breathe. Your back is the back of the box. Lean forward and place your hands above your waist at the back. You may feel movement there as you breathe. The front of the box is your diaphragm, with the abdominal muscles below it. Place one hand above and one hand just below your waist, and be aware of a movement inwards and outwards as you breathe. Use a bit of deliberate action to move the abdominal muscles if necessary. The base of the box is the bottom part of your abdominal area, where you may be able to feel your pubic muscles and the transversus abdominis muscle. See if you can increase a sense of healthy contraction in that pubic area. Place a hand just above your pubic bone, and blow out a strong shh, seeing how low you can feel a contraction. (An advanced version of this exercise is to try to deliberately breathe while moving all six ‘walls of the box’ – only as an exercise, not all the time!)

Breath 12: Awareness of rib movement option: sss–zzz with abdominal breath into rib involvement Blow all the air out of your body. Let the breath drop in and start a strong sustained sss sound, focusing on the movement of abdominal muscles inwards as the sound streams out. After a few seconds, turn the sound into a voiced zzz and let your ribs move inwards as that sound extends. This can also be done on fff into vvv.

Breath 13: Awareness of ribs and back: the yoga ‘child’s position’ Kneel down, sitting on your bent legs, and bend your head and torso forward as close to the floor as possible. Stretch your arms to reach either side of your head. Feel the stretch in the back, and focus your awareness onto your lower back. As your abdominal muscles are restricted by the position, you will feel your ribs and back expanding.

Breath 14: Awareness of strong abdominal muscle action: all fours Kneel down on your hands and knees. Make sure that you are comfortable. Spread your fingers out and feel their contact with the floor. Keep your back flat and straight. Contract your abdominal muscles inwards as you blow a stream of air out of your mouth between lightly pursed lips, directing it to the floor between your hands. Wait for a silent count of 1, 2, 3 – and then let your abdominal muscles go loose and drop down away from your back. As you do this, let your mouth open, and feel the breath rush in through an open throat, and fill your chest. Repeat several times.

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Then sit back on your heels or in a chair, and repeat the movements, directing a strong supported fff towards different points on the wall. Feel how the length of movement changes according to the distance. Finally feel that same strong support in a standing position. I often refer to the abdominal release movement that happens as the breath drops in as ‘letting it all go bleeagh’ and similar to Chapman’s (2006) term, the ‘SPLAT’ (singers please loosen abdominal tension). Depending on their own physique and personality, the quick release can make some people feel self-conscious because we rarely ‘let it all go’ like this. We can remind them that this ‘tummy drop’ is almost certainly hidden by clothes, and in a group no one is looking anyway! In a slightly different form this exercise is also a musclestrengthening exercise sometimes advised by physiotherapists to build lower back support.

Breath 15: Slowing down the breath: the Apple Mac exercise This exercise was invented for a stressed businessman whose habitual breath was fast and shallow; he had high blood pressure and told me that he felt that he often ‘hardly had time to breathe’. His computer was an Apple Mac laptop and, like other Apple computers, when this is on ‘sleep’ mode, it shows a small slowly pulsing light on the front. The pulses happen 12 times every minute, which happens to coincide with the average number of breaths. If a ‘desk-based’ client likes this idea (and has the right computer!) he simply puts his computer on sleep, sits back in his chair, stretches his arms for a moment and then for 3 minutes times his breath to coincide with the light pulses. This can deepen and slow the pattern, and gives a few minutes of awareness and calm in the midst of activity – without leaving the desk.

Breath 16: Placing the breath: introducing the feeling of active abdominal muscle involvement This is the kind of direction that can be used with a client who is new to the idea and practice of lower breath support: 1. Sit comfortably with your back and head supported, or lie on the floor in the semisupine position. Have one hand resting flat on your body just above your waistband and one hand just below. Feel their warmth or slight pressure. 2. Make a pretend laugh; you are quite likely to feel the muscles under your hands move. 3. See if you can breathe so that your hands move up and down. If the breath seems to be rising and falling higher up in your body, just observe that – and see if you can picture the breath moving lower down into your body. 4. Then make a deliberate movement. Pull the abdominal muscles in and out a few times, as if you were trying to get into a tight pair of trousers. Feel the strength of those muscles.

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5. Now – as you pull in on those muscles – blow out on a short fff or shh sound. Do this several times in quick succession. 6. If coordination feels difficult, keep one hand just below your waistband, and place the palm of your other hand in front of your mouth. Blow that stream of air on fff onto your hand as you pull the muscles inwards. Drop the upper hand once the breath is coordinated. 7. As you are doing these, notice that you do not have to deliberately take an active breath in – as you release the stomach muscles, the breath just drops in, low and centred, as it should be. The body is breathing without you having to ‘pull’ breath into your upper chest. 8. Make a strong shh sound in different imaginative ways: to a noisy child, to an adult talking too loudly on a mobile phone, in a flirty way, in a superior way, etc. Each time, feel that strong abdominal connection. Make sure that you are not pushing down but inwards. 9. Make the fff or shh sound last longer, so that the out-breath extends. At the end of each sound made on this out-breath, wait a moment until you recognise that your body needs to breathe – and then release the stomach muscles and let the breath drop in. Do not breathe any more often than you need to, as ‘over-breathing’ is not good for you. 10. Repeat 10 times. Note that, if at any point in these exercises you feel at all light-headed or dizzy, stop until this goes away, or until another day. As a client begins to coordinate breath with voice, patterns of extra throat tension may become clear; if so, we would introduce some channel deconstriction exercises before continuing with work on breath into voice.

Breath 17: Placing the breath: linking abdominal breath to voice Once the breath is connected to the abdominal muscles, we can point out that these support the diaphragm movements in breathing, so that a client no longer needs to use her upper chest muscles so much. We can then connect that lower breath to voicing: 1. Start any breath work by blowing all the air out of your body with a gentle but firm tightening of those abdominal muscles. Do this a few times, until you are back in that easy lower breath pattern. 2. Then, instead of blowing out on fff, as the breath flows out, make a very quiet mmm. Repeat it several times, feeling the connection between that lower breath and the sound, and ‘tune into’ your throat, to check whether you are also pushing in that area. (If so, yawn and sigh and see if you can release it.) 3. Now try the same thing on a quiet ooh or eeh or aah. Again, take time to feel that those lower muscles are powering the sound. 4. Then intone those sounds for a longer time. 5. Count from 1 to 10. Speak one number at a time, and let the breath drop in after each number, so that there is a new breath for each number. Feel the abdominal muscles ‘supporting’ the voice as the sound comes out.

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6. Then try out some single words: Hey! Well! What? Which? Where? How? No! Yes! Maybe. Never! Sometimes. 7. Then some phrases: Open up! Come on in. It’s very cold. Why on earth? I just don’t know that. Can you open this window? 8. Build up the length of the out-breath by increasing the sequences of numbers: 1; 1 2; 1 2 3; 1 2 3 4; etc. – up to a sequence of 10. Let the breath drop back in after each group. 9. Try out different pitches on some spoken phrases, sometimes high and sometimes low. 10. Explore how loud or strong the voice can be with increased lower muscle support and no strain or push in the throat. 11. Read out loud from a paper or book, consciously keeping the lower abdominal breath support working. 12. Finally practise abdominal breathing as you speak your thoughts, using short phrases and then longer sentences. At some point people often remark ‘But I’m doing it deliberately!’ or ‘It doesn’t feel natural’. I respond that of course it feels artificial, because we are training new mechanical muscle patterns, but gradually this will become automatic. We may need to point out that sometimes what feels unnatural is actually non-habitual. ‘You are working to establish a neuromuscular pattern for helping to take the strain off your throat. If practised daily for 2 weeks or so, it will gradually centre and settle until it feels more normal. It is not an ‘all or nothing’ thing, and there is no perfect pattern. Even if you gradually use 20% more lower breathing muscle involvement, that will be 20% less throat strain.’

Breath 18: Building abdominal–diaphragm breath coordination: panting With pursed lips blow out repeated short breaths on a ff ff ff panting pattern, and consciously feel those lower breathing muscles moving strongly inwards as each out-breath is propelled out between the lips. After each, simply let go of them to allow the breath to drop back into your body. Repeat 10 times, and do another set, so long as you are not feeling at all dizzy. Then repeat two more sets of 10, this time using the sound sss or shh. If this is working well, link the panting to a quiet voiced huh on each out-breath, making sure that there is no throat tightening. Panting is a useful exercise for improving both awareness and coordination of abdominal breathing muscles with breath. Some practitioners refer to panting as ‘waking up the diaphragm’, but, unless there is neurological damage, the diaphragm never sleeps!

Breath 19: To reduce audible inhalation: repeated counting A tight audible in-breath ruins singing and broadcast speech, and indicates unnecessary throat constriction. Miller (1986) writes: ‘Any noise resulting from the intake of breath

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between syllables indicates improper involvement of either the vocal folds or other parts of the vocal tract.’ Count 1 to 10 quickly out loud on one breath in an ordinary conversational manner, and at the end let a quick breath drop in with a deliberately open jaw and throat; then quickly repeat again – this time with a slightly less open jaw and throat. Check that you hear no audible in-breath, and then repeat again, this time with the lips hardly open, and no throat constriction. Repeat this last sequence several times. (This is one of the tasks in the VSPP assessment.)

Breath 20: To reduce audible inhalation: singing hey Sing a long note on hey, then let the breath drop in quickly with no constriction, and repeat the long hey on another pitch. Do several times, monitoring the sound of the in-breath and reducing any audible inhalatory friction.

Breath 21: To act as an instant reminder in ordinary life: silent breath pulses Sit comfortably, with your legs uncrossed. Rest a hand on your abdominal area for a few moments, and very quietly, so that no one can hear, blow a small breath out as you deliberately contract the lower breathing muscles. Let the breath come in silently. Concentrate on that sequence for 2–3 minutes, and then stop making any deliberate breath movements. Focus back on the work or leisure activity or what is happening around you but, every so often, tune back to see whether there is any sense of that lower breath. If not, reconnect!

Breath 22: To act as an instant reminder in ordinary life: quick shh, fft or huh Make a strong quick voiceless shh or fft sound consciously using quick abdominal support. Make it as loud or soft as your social circumstances allow. Then make a few quiet voiced huh sounds, still connecting, and speak out loud any learnt lines or spontaneous thoughts, with that same physical awareness.

Breath 23: To help establish a new implicit memory pattern: the solitary monologue To practise and ‘naturalise’ lower breath support, a client should talk out loud for at least 5–10 minutes, when alone and engaged in some solitary activity. This often links well to simple domestic tasks.

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The activity of ‘monologuing’ acts as a bridge between technical exercise and interpersonal communication. Real thoughts are expressed, but, because there is no communicative load, a focus can stay on the manner of voicing, rather than on meaning and listener response. This is useful for incorporating any new vocal pattern.

Breath 24: Connecting to ‘strong’ breath: the inspiration stretch The term ‘strong’ breath is an image used in physical exercises such as these as important preparation for strong, emotional or very loud voice. There are many variations. Stand with arms by your side. Stretch your arms up and out in a T shape with your body, palms of hands pointing upwards. Blow out on a long fff, or just breathe out as you bring your arms up above your head. As you hold them there for a moment, think of the word ‘inspiration’, with its two meanings of in-breath and creative empowerment, and picture those as you lower your arms and the in-breath drops deep into your body. Repeat the sequence

Breath 25: Connecting to ‘strong’ breath in movement: two arms swinging This uses the forward arm swings of the body exercise designed to loosen the shoulders. Stand in neutral. Make sure that your feet are hip width apart, pointing forward, and your legs are firm but not with locked knees. Take time to focus on the feeling of your feet contacting the floor. Slightly bend your knees and swing your right arm forward as your left arm swings back, then reverse and get a rhythm going. As you continue to do this let your legs flex a little in time with the arm movements. As one arm comes forward, blow out a long fff, and as the other comes forward let the breath drop into your lower body. Repeat a number of times.

Breath 26: Connecting to ‘strong’ breath in movement: one arm swinging with voice Stand in neutral. Make sure that your legs are firmly planted and that your feet are hip width apart, pointing forward. Take time to focus on the feeling of your feet contacting the floor. Slightly bend your knees and swing your right arm up and forward. As it swings down and back, let your knees bend and at the same time call a strong eeh or hey, with a falling intonation. Repeat a number of times, exploring the imaginative image that the sound is moved out of your body by your arm movement. Change arms when you want. As the energy and freedom in this build, you may want to start the arm movement above your head, so that you feel the power through your whole body as movement and voice become synchronised.

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Breath control Breath 27: Building control: counting Count out loud, using abdominal breath support and letting a quick breath enter after each sequence: 1; 1 2; 1 2 3; 1 2 3 4; 1 2 3 4 5; 1 2 3 4 5 6; 1 2 3 4 5 6 7; 1 2 3 4 5 6 7 8; 1 2 3 4 5 6 7 8 9; 1 2 3 4 5 6 7 8 9 10; etc. You can build this up as long as you feel that it is relevant for a particular client or group. At some point, I always ask clients to walk around the room as they do this – it is less boring and more realistic to normal breath and voice use! Control exercises such as this enable clients to see a clear improvement over time; similar to a typical gym exercise, vocal stamina, power and coordination all improve with repetition. All control exercises should also be done while moving around the room, and children particularly will generally find this more fun.

Breath 28: Building control: timing the long sss or zzz Ask the client to place a hand on her lower breathing area, and blow all the air out of her body on a strong sss. Suggest that she can just let the breath drop in. Ask her to concentrate on the feeling as this refills the top two-thirds of her lungs, and her abdominal area expands back to its previous position. Point out that she may also feel her ribs expanding sideways. Ask her to let the breath out as slowly as possible on a long sss. Then try a long voiced zzz. Count the number of seconds that she can make this last. If it is less than 15, suggest that she works on this at home to gradually build this up. (Norms for this task can be found in Chapter 8.) It can also be done on a long vowel sound, but check that there is no ‘holding’ in the laryngeal area.

Breath 29: Building control: stop–start on sustained sounds Make a steady fff or shh, making it last as long as is comfortable. While it is flowing out of your mouth, stop and start it several times, controlling it from your abdominal muscles or rib action. Do not take any breath when you pause, until you run out of breath. (If watching a client, make sure that she is not tightening the face or lips to achieve these stops.) Then do the same on a voiced mmm, nnn, nng or a vowel. (This time, ensure that the client is not using lots of tense glottal stopping to achieve the breaks; the control should be focused in the lower breathing area.)

Breath 30: Building control: crescendo–diminuendo in sustained sounds Make a steady fff or shh, starting off very softly and then getting louder and louder in a crescendo. Make sure that the increase in loudness is coming from the breath support and does not involve tension anywhere along the channel. Depending on a client’s breath

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control, you might have 5 seconds of soft followed by 5 seconds of loud, or 7 or even more of each. Start short – you can build up. Then do a sequence of soft to loud to soft on those voiceless sounds. This requires good breath control so that enough air remains after the crescendo for there to be a controlled diminuendo (becoming quieter) into silence. Again, start with a few seconds of each and encourage the gradual building up of this control. So – fffffffffffffffffffffffffffffffffffffffff and build up length of times if possible. 5 seconds 5 seconds 5 seconds

These exercises are relevant for those times in lively noisy chatting when we reach the climax of information or excitement in the middle of a sentence, but still need breath control so that we do not go into squeeze mode as the subglottic air pressure drops.

Breath 31: Building control: the slow glide On a long eeh or ooh move slowly up in a long scoop from the bottom of your pitch range to the top, and then down again. Make sure that you have enough breath control so that you do not have to rush down, but the rise and the fall should take the same time. If it is easy, do it again – more slowly. I tend to use this version of the glide (so useful in phonation and pitch work) with professional voice users, particularly singers who need excellent breath control. It is a surprisingly demanding exercise, but practice makes for audible improvement.

Breath 32: Strong controlled abdominal support: the rolled rrr or the blown brrr (the ‘raspberry sound’) I learnt these exercises from singing teachers, and they are clearly described in Chapman (2006) who says that they place ‘an insistent demand on the airflow and support’. Carroll (2000) describes the blown brrr as assessing the coordination needed to balance ‘respiratory, source and filter subsystem’ – breath, phonation and resonance. Place a hand on your lower breathing area. Blow all the air out of your body, let the inbreath drop in low and then blow a strong rolled rrr for as long as you can. If you cannot make a rolled rrr (and some people cannot) use a long lip-blown brr, i.e. a lip trill rather than a tongue tip trill. Vary it by going up your pitch range on that sound, or by making a crescendo as it moves from soft to loud.

Breath 33: Breath flow in action: paper tissue on wall Take a small piece of a paper tissue, and hold it against a wall. See if you can keep it there throughout the period of a strong out-breath through pursed lips without holding it. Many of these breath exercises need adaptation for work with children; this old one needs none!

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Breath 34: Placing and control: the Accent Method The Accent Method was developed by Danish speech therapist, speech scientist and phonetician Svend Smith in the 1930s. Kotby (1995) describes it as a ‘holistic approach to the treatment of voice’. It has become popular with many SLTs and some singing teachers, who usually use the two core aspects of its structured approach: 1. A strong emphasis on abdominal breathing. 2. Sequences of rhythmic phonation moving from voiceless sounds through vowels, consonants, words and phrases. The word and phrase stresses are accentuated and linked to body and/or breath movements. Most practitioners who use the Accent Method tend to modify its sequences and adapt them for their own purposes. (Fewer use the accompanying drumbeat, an integral part of the original Accent Method movements. Smith’s approach was inspired by contact with Mr Bogana, the West African drummer in singer Josephine Baker’s band.) Voice teachers have long used repetitive rhythm, lower breath and sound in their own work; the Accent method formalises this.

Imagination and breath We can add an imaginative element to many of the physical exercises above, e.g. in exercise 18 we can ask a speaker to imagine feeling a situation that makes him nervous as he pants; in exercise 30 we can suggest that a group uses the power of crescendo to lift the ceiling up. Below are three examples of specific exercises that link imagination and breath; there are many others.

Breath 35: Control in imagination: action breaths (Inspired by Grotowski 1975.) Using a prolonged fff, shh, sss or simple lip-blowing sound, imagine making your breath do things. A few examples: Blow out a candle. Stroke a cat. Punch holes into a board. Kick a ball across the floor. Squeeze through a narrow tube, and then rush through a wide tunnel. Write your name in the air. Paint a fence red. Wrap a parcel. Spread a rug out on the grass. Saw a piece of wood. Make a fire burn better. Kiss a number of friends.

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Breath 36: To deepen the breath in imagination: the tree (There are different versions of this exercise; this one comes from James Roose-Evans 1994.) Stand in the neutral position. Focus on the feeling in your legs and feet and picture them as having roots that go into the ground below you. Blow all the air out of your body and, when you breathe in, or let the breath in, picture it coming up from the ground into your feet. In your mind’s eye, see and feel it flowing up your legs and vertebrae, right up to the top of your head. Pause for just 2–3 seconds, being aware that you are neither breathing in nor out, then let the out-breath cascade down the front of your body back into the ground. Again ‘rest in the emptiness of no-breath . . . familiar to those who do breath meditation’. Repeat several times, allowing the experience to deepen.

Breath 37: Connecting breath to centres of imaginative energy: chakra breathing In many branches of eastern thought, the chakras are seen as points of energy. D’Angelo (2000) calls them ‘receptors, mediators and distributors within the body of subtle energy’, and describes the view that they regulate and link to the endocrine glands, and so to emotional and physical body states. Whether or not you are open to such ideas, imagining that your breath is connecting to these different foci in the body can be a calming and strengthening experience. I use chakra breathing with carefully selected individual clients and groups, and may introduce the idea as ‘centres of imaginative energy’. Sometimes I use the breath alone, but occasionally feed in the idea of breathing in a particular related emotional quality into each place. This can sometimes help a person to connect to those qualities in his life. The traditions have slight variations in the exact definition of each place; these are the ones that I use (Table 19.1). Ask the client to lie or sit comfortably with head and back fully supported, and to close her eyes. Slowly talk her through a sequence of breathing into each of the energy centres in turn. You can start at the top of the head or at the base of the spine, but take enough time for the person to imagine the breath, and image, going into each place.

Table 19.1 The chakras or imaginative energy centers.

Name of chakra

Place in body

Quality of energy

Crown Centre of brow Throat Heart Solar plexus Sacral Root

Top of head Centre of forehead Hollow below larynx Centre of chest, between breasts Diaphragm area Just below navel Base of spine

Connection to light and spirit Vision and inspiration Communication Love Centred strength Creativity and sexuality Stability and groundedness

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After this exercise, it is particularly important to allow time for discussion as to how the person felt, and whether she wants to use it again in any way.

Text Actors have to learn to manage the long thoughts of classical text on one breath, and singers need to sustain breath and voice quality through any length of song line. Both work with breath and texts in their training. Many non-performer clients like the security of texts to practise breath control. One of the simplest exercises is to use sentences of increasing length to stretch breath control. You can make up your own; here are two examples.

Breath control in sentences of increasing length Speak with high energy and urgency, with just one breath at the start of each sentence. Move quickly down the list: 1. 2. 3. 4. 5. 6. 7. 8.

9.

10.

Fraser has left. But Fraser has left college. But Fraser has left college and gone to work. But Fraser has left college and gone to work for an estate agent. But I tried to tell you that Fraser has left college and gone to work for an estate agent. But I tried to tell you that Fraser can’t join the company in the summer because he’s left college and gone to work for an estate agent. But I tried to tell you before the meeting that Fraser can’t join the company in the summer because he’s left college and gone to work for an estate agent. But I tried to tell you before the meeting that Fraser, who would have been ideal for us, can’t join the company in the summer because he’s left college and gone to work for an estate agent. But I tried to tell you before the meeting that Fraser, who would have been ideal for us, can’t join the company in the summer because he’s left college and gone to work for an estate agent, who’ve offered him training and a good salary. But I tried to tell you before the meeting – you were on the phone – that Fraser, who would have been ideal for us, can’t join the company in the summer because he’s left college and gone to work for an estate agent, who’ve offered him training and a good salary.

Yes, I do know that you would probably naturally breathe where you see commas or dashes, in those pauses between thoughts, but this is an exercise!

Breath control in ‘passionate commitment’ sentences 1. I believe in this man. 2. I believe in this man because he is honest and will stand by his promises. 3. I believe in this man because he is honest and will stand by his promises no matter what threats are made against him by an opposition, which has no morality.

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4. I believe in this man because he is honest and will stand by his promises no matter what threats are made against him by an opposition which has no morality in the face of his excellent policies and shining integrity.

Nursery rhymes or limericks It should be possible to say a nursery rhyme or limerick on one breath. If this is too easy – slow it down. There was an Old Lady of Chertsey, Who made a remarkable curtsey; She twirled round and round, Till she sunk underground, Which distressed all the people of Chertsey.

Poetry and prose We can also use a wide variety of texts for speakers to coordinate breath and voice. These may include newspaper extracts, magazine articles, scientific journal pieces, poems, play texts, and child or adult fiction. The two important provisos are that whatever is used is absolutely suitable for the person, and that a great piece of text is never massacred by being used as an exercise. Once a client has mastered the basics of breath, I may ask him to choose a poem, from poems he may know or selected from my own collection of others’ poems. We work with this, allowing the right breath placing to be found as he explores the poem. I am grateful to the poet Mario Petrucci for allowing me to include part of his Chernobyl poem here. It is a masterly example of how the words, images, phrasing and structure of a poem are absolutely integral to its meaning, and can shape the breath pattern of both reader and listener.

Breathing by Mario Petrucci

They had to teach me from scratch. Teach me to breathe. As though I had fallen out of space or up from water and breath was labour – each breath a pang to draw me back from the brink. In. Out. In this world life is indifferent. You must will it in. Will it

Breath Voice Exercises out. I look at my son – those white cheeks that tight frown and I wonder how I can breathe. He says – Mama when you go to sleep tonight please don’t forget to breathe. Please. He is not allowed to run. Or jump. Like that boy who hanged himself with a belt. I watch him. And he watches me – when I doze on the red sofa he rests a hand to check the rise and fall of my chest. Tells me he will teach me in his dreams – will teach me to breathe if I teach him how to fly. If you go with Grandpa he says – will you be able to breathe? He says this and his cheeks run wet and he runs short of breath so we sit once again to teach each other how — deep and slow. We are flying I tell him. We are breathing

he replies.

From: Heavy Water: a poem for Chernobyl (Enitharmon Press, 2004). (Reproduced with the permission of Mario Petrucci.)

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Chapter 20

Channel voice exercises

The free voice has a passage through the channel with appropriate settings of face, lips, jaw, tongue, soft palate, pharynx and larynx, and no excess muscle constriction.

The face Face 1: To liven up sensation in the face: tapping Use both hands, left hand on left cheek and right on right, to tap all over your face with the fingertips. Work along the jaw line, up and down the cheeks, round the mouth, round the eyes and over the forehead. Be careful to avoid touching the eyes themselves. Be firm enough to create a tingle but not so hard that it hurts. Take about a minute in total.

Face 2: To release and identify the main facial muscles: self-massage Gently but firmly rub the muscles of your face and neck with your fingertips; if you want to follow specific muscles, use Figure 9.3 (page 147) of the facial muscles in Chapter 9.

Face 3: To tighten and then release facial muscles: a string from the nose Imagine that there is a drawstring attached to the tip of your nose. When you pull on that string, the whole of your face tightens and puckers up towards that nose tip. Tighten all your facial muscles, until your entire face is tightly screwed up – scalp, eyes, forehead, cheeks, lips, inside of mouth, tongue and nose. Hold for about 10 seconds and then, very slowly, imagine that the string tension eases so that the tension releases. Imagine the sense of widening and release spreading out into your hairline and the back of your mouth.

Voice Work: Art and Science in Changing Voices. Christina Shewell © 2009 Christina Shewell. ISBN: 978-0-470-01992-4

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Face 4: To stretch the facial muscles and increase ‘mask awareness’: pulling faces That’s it really! You can either do this as a simple ‘imitate and explore’ exercise, or ask people to pull faces for particular emotions or situations. Take long enough for the face to have a real ‘work-out’.

The lips All lip exercises naturally affect the whole face as well.

Lips 1: To loosen the lips: rubber lips Put your index finger horizontally between your lips and move it up and down so that it pushes your top and bottom lips up and down; at the same time let a voiced loose ‘rubbery bbb’ sound emerge. Moving the tongue at the same time creates some interesting resonances.

Lips 2: To loosen the lips: lip blowing and kissing Blow your lips like a passionate horse on ‘brrrr’. Move up and down your pitch range. Blow some ‘rude’ raspberry sounds. Make some loud kissing noises as if sending the kisses across a large space to a flamboyant friend.

Lips 3: To stretch the lips: hot potato Imagine that you have a hot potato in your mouth – let it affect the whole shape of your face and mouth as you try to cool it down.

Lips 4: To stretch the lips: specific exercises Do each 5–10 times: • Keep the lips closed as you stretch them into an enormous smile – hold for 5 seconds – then tighten lips and hold in a silent whistle setting for 5 seconds. • Lift your top lip as high as you can towards the nose and then pull it down. • Push out your bottom lip as far as possible. • Now do top and bottom lip protrusion together.

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• Turn the corners of your lips down, and then up. • Imagine a fly creeping round your mouth; try to shift it by moving all that muscular area around your lips, bit by bit. • Fish mouth: push lips forward in an open mouth setting (quite difficult!) and open and close your lips like a fish, with a slight ‘buh buh’ noise. • Sneer: bring one corner of your lips up towards your left nostril, and then do the same on the other side (one side is usually stronger than the other, which is normal and unimportant). • Snout and grin: push lips forward, curl lips outwards like the shape of a pig’s snout. Hold for 10 seconds, then open mouth and stretch lips out in the widest grin possible.

Lips 5: To stretch the lips: two vowels • Move between oo and ee as fast as possible, with an awareness of strong lip movements. First of all silently, and then with voice. • Then on moo mee as fast and extensively as possible on one out-breath. • Then on boo bee in the same way. Use any other consonant that you want.

Lips 6: To stretch the lips: five vowels • Whisper the five vowel names A E I O U (eh–ee–aye–oh–yoo). Exaggerate the movement of your lips as they shape the different sounds. First do them with little jaw movement, and then let the jaw also be involved in their shaping. But be careful to check that there is no inappropriate neck muscle tightening. • Then intone those vowels, as again you feel your lips fully shape them. The tongue will still move but focus on the sensation of your lip movements. • Then repeat several times with the sound /m/ before the vowel – meh mee my moh moo.

Lips 7: To encourage extensive lip movement: ‘bad’ French accent Count, read or speak or for 1 or 2 minutes as if you were speaking in an exaggerated French accent, with lots of lip rounding, protrusion, spreading and stretching. Try not to distort any other aspect of your voice as you do this. Then revert to a normal range of lip movements, but keep an awareness that the lips can move energetically.

Lips 8: To encourage extensive lip movement: whispering or mouthing Explore the feeling of lip movements as you whisper words, sentences or poetry or prose texts.

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In a group, work in partners and have one person quietly whisper messages to each other across a metre of space; the ‘listener’ has to decipher the message from the lip shapes.

Lips 9: To encourage extensive lip movement: the ‘miaouw’ limerick Speak a series of ‘miaouw’ words in the traditional limerick rhythm, really stretching the lips extensively. They can be intoned or even sung to a made-up tune: Sample limerick for rhythm: There was an Old Man in a tree, Who was horribly bored by a Bee; When they said, ‘Does it buzz?’ He replied, ‘Yes, it does!’ ‘It’s a regular brute of a Bee!’ Miaouw Miaouw Miaouw Miaouw Miaouw

miaouw miaouw miaouw miaouw miaouw

miaouw, miaouw, miaouw, miaouw, miaouw,

miaouw miaouw miaouw miaouw miaouw

miaouw miaouw, miaouw MIAOUW miaouw miaouw, miaouw MIAOUW MIAOUW MIAOUW miaouw miaouw, miaouw MIAOUW!

Lips 10: To encourage extensive lip movement: singing ‘many men’ Sing the William Tell Overture with the words ‘many men’, or use any other fast, energetic tune that you know and like! Use a pattern of strong and extended lip movements.

Lips 11: To encourage extensive lip movement: speaking in wibble-wobble Say wibble-wobble as fast as possible several times. Speak several longer utterances using only the sounds wibble-wobble. Use a pattern of strong and extended lip movements, and vary the pitch in a kind of mock-conversation manner. In a group, work in partners and have one person use only this sound to communicate to another about an exciting event that once happened.

Lips 12: To encourage extensive lip movement: silent and then voiced ‘wows’ Mouth and then speak a sequence of five ‘wows’, which build in energy and excitement. Start on a rather dull and quiet wow, with little lip movement and end with the widest

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mouth that you can do, with huge facial excitement. The sequence does not have to increase much in loudness, just intensity of movement. You can use whoah, or well, or wubbadubbadoo – or any other word or nonsense sound! In the same way, the important thing is to strongly and fully shape both the lip sounds and the vowels.

The jaw Exercises aim to release any excess tension in the jaw joints and to encourage a comfortable range of easy movement when speaking. As described in Chapter 9, care needs to be taken with jaw exercises; suggest that the client asks his dentist for advice if there is any pain or clicking.

Jaw 1: To enable the client to be aware of jaw position: the jaw-drop test Ask your client to sit comfortably with his legs uncrossed. Say something like: ‘Let your lower jaw drop to a comfortable degree. Don’t force it, it’s not a yawn or a stretch, simply see if you can get the sense that it is comfortably dropped and loose. Then try to sense how many fingers you could insert in a vertical dimension between the top and bottom teeth; would it be one? Two? Three? It’s important that you do not actually test this out with your fingers – just imagine doing it.’ Make sure that the client does not put his fingers between his teeth, as the point is to see how wide open he senses his mouth to be. Tell him that, once he has an image of how many fingers would fit, he should hold up that number of fingers beside his head. Watch what he does, and then ask him to see if those fingers will fit between his teeth, to check out the accuracy of his sensation. Most people over-estimate, and you can then discuss the fact that we may think that our mouths are more open than they are; this can lead to resistance to many other ‘voice release’ exercises. We are brought up not to open our mouths too wide and can feel exposed when we start to ‘open up’, but the jaw can be free without the mouth being excessively open. This exercise was developed while working with a group of ‘tight-jawed’ bankers – all men – who suddenly realised that they felt that they were being asked to release their tight jaws to a dangerous degree. It is useful for any client for whom a tight close jaw is relevant.

Jaw 2: To enable a speaker to be aware of jaw position: tuning into habitual settings Ask the client to ‘attend to’ the sensation in her jaw joint as she sits quietly. If she identifies that she tends to clench her jaw (often associated with night-time teeth grinding), she is likely to benefit from jaw release work.

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Jaw 3: To enable a speaker to be aware of jaw position: mirror work Ask the client to sit in front of a mirror and have him watch his mouth and face as he talks with you. Many clients are amazed at how close and tight their jaw setting appears.

Jaw 4: To develop a new pattern in the muscles of the temporomandibular joint: the one- and two-finger drop Stand in front of a mirror and open your jaw until you can place the tip of your index finger vertically between your upper and lower teeth. Intone lah lah lah and then A–E–I– O–U several times, and feel the front of your tongue rise and fall energetically. If the one-finger drop is not uncomfortable (Figure 20.1), place the tips of your index and middle finger vertically between your upper and lower teeth, and repeat the same sound sequence. Now take the fingers away and explore speaking with that same open posture. Of course your jaw will open and close with the articulation of sounds, but it will not remain in a tight setting.

Figure 20.1 One-finger jaw drop.

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The mirror can be a useful introduction to the idea of jaw work, but should be used only briefly here since the aim is to encourage a proprioceptive sense of the space between the teeth – the easiest way for a client to judge the degree of their jaw opening. In general, I encourage performers to be able to use two-finger drop exercises (not in ordinary speaking), and work the idea of a one-finger drop with a non-performer. For many years student actors practised articulation exercises with small bone props held in a vertical dimension between their top and lower teeth. These are still available and used sensitively by a few practitioners (see websites in Appendix I).

Jaw 5: To demonstrate the effects of a subtle jaw release: ‘watch my lips’ Having demonstrated how the space between the teeth can relate to jaw release, some clients may need reassurance that they can let go of excess jaw tension and not look different. Start speaking with a deliberate excess tension in your jaw joint, and try to feel this at the back of your mouth and around the temporomandibular joint (TMJ). (There is a relatively narrow gap between your teeth but they are not clamped together.) Make sure that the movements of your lips are lively, but you should ensure that there is a restricted resonance from the jaw tension and the narrower space at the back of the mouth. After a few sentences, subtly release your jaw tension, but do not greatly increase the space between your teeth or your range of lip movements. You should be able to hear that the resonance has changed as the jaw tension has lessened.

Jaw 6: To develop a new pattern in the muscles of the TMJ joint: the dropped jaw Let your jaw drop into a completely released ‘hanging loose’ position with your tongue tip behind your lower lip. Keep it in this position for at least a minute, and do this three times a day. Do this as you sit, drive, walk, watch television, chop onions or any other solitary activity. This was the way that I changed my own habitually tight jaw setting as a student voice teacher. Over the period of 3–4 weeks, when alone, I drove around with this posture for 10–20 minutes at a time. Gradually a new nerve–muscle pattern was laid down, as the TMJ joints ‘recognised’ that they could release.

Jaw 7: To release jaw tension: open wide Open your mouth as wide as is comfortable. Keep your tongue flat in your mouth, with the tip just behind your lower teeth. Picture the back of your mouth and throat as a wide cavern opening into the depths of your chest and let the breath enter through that wide

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opening. Feel the stretch and let the breath come in and out for two to five breaths, keeping jaw and throat open.

Jaw 8: To release jaw tension: rubbing down Let your jaw drop very slightly. Place the balls of your hands just under your cheekbones and firmly rub down into the hollows of your cheeks at the same time as you let the lower jaw drop into a more open position. Repeat two to three times.

Jaw 9: To release jaw tension: finger-tip jaw massage Use the fingertips of both hands to rub in front of both ears, as you slightly open and close your jaw. Feel around the jaw joint, and explore the muscles around it with a gentle pressure of your fingers.

Jaw 10: To ensure no unnecessary neck muscle tension: neck massage Sometimes clients will tighten the neck muscles as they try hard to do jaw or tongue exercises. You will need to point this out, and encourage them to place a hand on that area to see if this sensory biofeedback helps to release inappropriate tension. I occasionally identify the main muscles that may be tightening by name (scalene, sternocleidomastoid and levator scapulae). You might want to gently massage these, or show the client how she can massage them herself during a busy day (Figure 20.2).

Jaw 11: To release jaw tension: face shaking on sound Tip your head slightly forward and let your jaw, lips and facial muscles be as floppy as possible as you vigorously shake the face from side to side. At the same time make a kind of buuuurh sound, letting that be affected by the shaking. Now let your mouth open slightly wider and change the sound to aah, as you still loosely shake the face and jaw.

Jaw 12: To release jaw tension: simple open and close At socially appropriate moments throughout the day, simply open and close your mouth five times, with an awareness of a slightly increased stretch but no forcing.

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Figure 20.2 Rubbing down the sternocleidomastoid muscles.

Jaw 13: To release jaw tension: a bubble of oil Let the jaw drop to a comfortably loose position, and imagine that there is a small bubble of health-giving oil in that joint. Open and close the jaw joint very slightly, and picture that little bubble of oil being moved around inside the joint by your movements.

Jaw 14: To release jaw tension: chewing Imagine that in your mouth you have a delicious morsel. Chew for a minute (that 60 seconds may feel like a long time), feeling the jaw joint open and close, and letting the tongue be fairly far forward in your mouth. Do silently for 30 seconds, and then with voice for another 30 seconds.

Jaw 15: To release jaw tension: chewing with blocked ears Put your fingers into your ears, and intone a quiet but steady mmm keeping your lips closed. By moving your jaw into open and closed positions, by wrinkling your nose and by moving

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your tongue inside your mouth, you will change the sound of the hum and it may feel as if it is moving round inside your head. For some people, the eustachian tube may ‘pop’ open, and you will suddenly hear an extra loud resonance in the sound.

Jaw 16: To extend jaw movement: talking through a glass wall Tell the client that you are imagining that you are communicating through a thick plate glass wall. You both have to mouth a brief message, trying to work out what is being said. Then ask the client to speak to you in a quiet voice with less movement, but still keeping that awareness of the increased possibility of jaw movement.

Jaw 17: To release jaw tension: over-speaking Speak for 2 minutes with exaggerated jaw movements but still in as ordinary a voice as possible. Then revert to the normal settings but feel that increased sense of space and freedom in the jaw movement.

Jaw 18: To encourage awareness of upper and lower jaw: Dr Ling’s larynx opener Grotowski (1975) describes this as a ‘basic exercise to open the larynx’, but it is in fact much better seen as a jaw release exercise. I have reworded it. Stand with your head and torso bent slightly forward. Let go in the jaw joint, and lightly hold the lower jaw between your finger and thumb, keeping the muscles of chin and upper neck soft. Your index finger rests lightly below the lower lip to prevent the lower jaw from dropping completely open. Raise your upper jaw and the eyebrows, at the same time wrinkling the forehead. Slightly tighten the muscles at the top and back of your head and the back part of the neck, so that your face and head feel as if they are lifting away from the lower jaw. Do not drop or move your lower jaw backwards. Let your voice come out on a long aah.

Jaw 19: To release jaw tension: the jaw shiver Place the back of one hand under your chin, let go in the jaw joint as much as you can, and push your lower jaw up several times in a kind of shivery movement with or without voice. This can be quite difficult for anyone who holds any tension in the jaw, so do not aim for perfection; just see if you can get a little feeling of how the jaw can be moved by the hand, rather than moving itself.

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Jaw 20: To release jaw tension: dropping the wine cork Tip your head slightly forward. Imagine that you are holding a wine cork between your teeth, not clenching your jaw, but with just enough tension on the closure to hold the cork steady. Then imagine releasing your jaw enough for the cork to fall out. Feel the difference in the tension in your jaw joint.

Jaw 21: To release jaw tension: downward ‘wohs’ (From singing teacher Andrew Hambly-Smith.) Speak or sing a series of woh sounds down a scale from high notes to low notes; let your jaw bounce open quite widely as you say each sound. If the word ‘sing’ does not sit comfortably with you or the client, use the instruction to ‘speak from high voice to low’.

Jaw 22: To stretch the jaw: silent scream Let the jaw drop, and then open it a bit more. Open your eyes wide. Feel a stretch at the back of your mouth and let the breath come out as if in a silent scream. Use your hands and arms as a melodramatic adjunct if you want!

Jaw 23: To release jaw tension: ooo-waa-waa Intone on one note a long ooo with lips quite rounded and close, and then suddenly change the sound into waa waa as you quickly drop your jaw and open your mouth. Do several on each out-breath, and repeat the sequence 5 –10 times. Improvise as you wish – perhaps going up a scale or singing a simple tune with these sounds.

Jaw 24: To release jaw tension: closed and open speaking Let your teeth touch together, without excessive pressure, and speak with that pattern for about 30 seconds. Then simply let the teeth separate and the jaw relax and speak normally; you may notice an increased awareness of both the resonance and articulation of speech sounds. Boone (1982) describes a similar technique, and suggests clenching a tongue depressor (I would use a wooden lollipop stick) between the teeth while counting or other serial speech, and then feeling the difference after discarding the restriction.

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The tongue Tongue exercises aim to release any excess tongue body or tongue root tension, and to encourage a range of movement within the mouth. They can also help to increase clients’ awareness of tongue positions, important when teaching dialect or doing specific work on the articulation of vowels or consonants.

Tongue 1: To tune into the tongue position: the resting state Sit symmetrically in a comfortable chair that supports your back and head, with legs uncrossed and feet on the ground. Close your eyes and try to feel your tongue inside your mouth. Where is the tip? Where is the middle? Is it flat and relaxed or tightly held up against the roof of your mouth? Is it towards the front of your mouth, or pulled back towards the back of your mouth? We often focus on doing tongue exercises, but it is also important to know what the tongue does for all of those hours when we are not speaking. The field of myofunctional therapy addresses the effect that habitual tongue resting positions have on teeth and jaws in both children and adults.

Tongue 2: To identify the tongue base and its muscle action: feeling underneath the tongue Put the tips of your finger and thumb under your lower jawbone, on the soft under-part of your chin (where a ‘double chin’ would be if you had one). Push up gently. If you say a strong hee several times, you will probably feel stiffening in that area under your jaw.

Tongue 3: To release excess tongue tension: tongue base jiggle Place your index finger horizontally under your chin, near the front of your lower jawbone. Let your tongue lie as flat and floppy in the mouth as possible. Intone a quiet and slightly breathy aah sound as you quickly and firmly push the finger up and down against the soft tissue of that area (Figure 20.3). Aim straight upwards not back towards the larynx. As you do this, the back of the tongue will be pushed up towards the soft palate, and you should hear a kind of gagagaga gargling-type sound. If the sound that emerges is like a tight aaah it gives a clue that the tongue is held too tightly, because it will not release upward to contact the palate.

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Figure 20.3 The tongue base jiggle.

Tongue 4: To release excess tongue tension: the lion yoga exercise Drop your jaw and protrude the tongue as far as it will go for 30 seconds – feel the pull on the tongue root. Have a hand on the side of your neck to make sure that you are not tightening those muscles; the energy should be in the tongue. Breathe. Put your tongue back (and if necessary wipe your chin). See if you can still feel a stretch in the tongue root.

Tongue 5: To release excess tongue tension: cleaning the mouth Imagine that you have just eaten something delicious and it has left traces throughout your mouth. Use your tongue tip to move into every part of your mouth, between lips and gums, behind teeth, along the palate and along the floor of your mouth. Count the tops of all your teeth, top and bottom. How many can you feel?

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Tongue 6: To increase tongue awareness: ‘tenderise’ the tongue Very gently press your teeth into all the different parts of the tongue that you can reach. Keep this very soft and tender; biting, gnawing and chewing will hurt and are not required!

Tongue 7: To stretch the tongue: licking your arm. (From singing teacher Mark Meylan.) Stretch your left arm out in front of you, palm facing up. Now bend it at the elbow, so the forearm comes in towards your face, but not too near. Extend your tongue as you pretend to try to reach the inside of that forearm to mime the action of licking up it. Feel the stretch in the floor of your mouth and the tongue root.

Tongue 8: Tongue release: undulating forward (Based on an exercise of voice teacher Kristen Linklater 2006.) Place the tongue tip just behind your lower teeth or lower lip, and keep it firmly in that place. Drop your jaw to a comfortable position. Push the tongue forward, as if out of your mouth, so that the body of it moves forward and you feel the stretch as the tongue ‘hump’ protrudes and flattens. Do 10–20 times. You can breathe normally as you do this, so that the movements occur on both in- and out-breathing. Or you can coordinate it with the out-breath alone, and imagine that the air pushes the tongue forward, as if moving like waves on the sea.

Tongue 9: To loosen the tongue in voicing: flippy-floppy flapping Turn the tip of your tongue under the back of your top lip, and then flip it backwards and forwards, loosely and quickly, between your lips in that kind of flippy-floppy noise that children sometimes make. First do this silently, and then with voice, in a loose bleah bleah bleah.

Tongue 10: To loosen the tongue in voicing: tongue thrust talking Put your tongue tip between your lips and speak for a minute or two like this, keeping the tongue quite floppy. It will sound dreadful of course but will give a sense of a forward placed tongue with no tight backing tendency. Then go back to normal and keep just a little sense of that loose, forward-in-mouth placing.

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Tongue 11: To increase awareness and extend the range of tongue movement: ventriloquist talk Let the jaw drop (to about one finger-width), keep your lips in a slightly spread position and read or speak as if you were a ventriloquist. Your lips and jaw need to be as immobile as possible but not tense. This requires the tongue to work very hard to make the precise and different placements needed to ensure that the vowels and consonants are clearly intelligible, and helps increase awareness of the tongue in the oral space. This is useful for those people who set their tongues in a central mouth position, and rely on jaw and lips to disambiguate their indistinct speech. If you create a few sentences that do not have any m, b, p, f, v or w consonants, you avoid the need for the speaker to substitute other non bi-labial consonants, e.g. ‘I don’t know how you could go there on such a dreary day and ask Keith to run around in hardly any clothes!’

Tongue 12: To increase awareness and extend the range of movement: five vowel intoning Let your jaw drop slightly open in a relaxed position. Round your lips into a closed lip oo position. Make a strong and sustained mmm sound and then open the mouth very slightly, but still keep the sound coming out of your nose in a kind of nasal, droned oo quality. Breathe when you need to but let this sound be sustained for as long as you can, while at the same time you shape the vowels oo or ah er ee. Repeat two to three times on each outbreath. Close your eyes and focus on the sensation as the tongue really works to shape those different vowel qualities. As you do this exercise you may hear some overtones of the vowels, which will sound like high bell-like notes. This vowel sequence is one of the ways to produce overtone chanting, and is repeated in the resonance section.

Tongue 13: To loosen and move the tongue but not the jaw: yeh yeh yeh Put your tongue tip behind the lower teeth and keep it there. Speak or sing down a number of notes on the sound yeh. Feel the tongue not the jaw working to make the fullness of those sounds. Do several on each out-breath, and repeat the sequence 5–10 times. Then improvise as you wish on that same yeh sound, perhaps speaking an imaginary conversation or singing a simple tune, just with the sound yeh.

Tongue 14: To change a habitual tongue setting: using contrasts in consonants and vowels In his voice programmes for adults, Boone (Boone 1982; Boone and Wiley 2000) lists words and sentences to use when working to alter a long-term habitual tongue position. His focus

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Please eat the sweet peaches (tongue body forward and raised)

Harry was standing by the back taxi rank (tongue body forward and lowered)

Do choose the goose soup for two (tongue body backed and raised)

Charles’ heart was far harder than Mark’s (tongue body backed and lowered)

Figure 20.4 Practice sentences for tongue body placing, related to the cardinal vowel chart.

is primarily on consonants. Words beginning with t/l/v/d/t/f encourage forward tongue position and c/k/g words encourage awareness and placing of a more backed tongue position. We can also focus on tongue settings through vowels. Start by showing the client or group a simplified version of the IPA (International Phonetic Association) cardinal vowel chart (Figure 20.4). Explain how this relates to the inside of the mouth, and how vowel shapes are made by varying the position of the tongue. Clients may not know this. Take each of these four key vowels in turn and explore them with a client, getting him to make these with you. Closing the eyes can help focus sensation on how they are made in the mouth. Once that can be felt, practise speaking sentences that have a focus on each of those positions in turn: Please eat the neat sweet peaches (tongue body forward and raised) Harry was standing by the black taxi rank (tongue body forward and lowered) Charles’ heart was far harder than Mark’s (tongue body backed and lowered) Do choose the goose soup for two (tongue body backed and raised)

Then (and this is harder but important) ask the client to consciously change his tongue body setting in one of those sentences and feel and hear the difference. For example: Please eat the neat sweet peaches said with the tongue body backed and lowered. Charles’ heart was far harder than Mark’s said with the tongue body forward and raised.

The soft palate The first aim of direct soft palate exercises is to increase a client’s awareness of its sensation and effects. The exercises are done slowly, with a calm focus on both sound and feeling. Resonance exercises in Chapter 22 also relate to the soft palate, because its actions create or limit the head or nasal resonant quality. The work of speech and language therapists includes specific techniques with people whose palate movement is severely impaired as a result of nerve damage or structural limitations. There is now a range of specialist biofeedback equipment to help with this work.

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Soft palate 1: To become aware of soft palate movement: nose and mouth breathing Let your mouth stay slightly open for this exercise. Breathe in through the nose and out through the mouth. You feel a slight movement at the back of your tongue and mouth; this is the soft palate lowering as you breathe in and rising as you breathe out.

Soft palate 2: To become aware of soft palate movement: looking in a mirror Angle a hand-held mirror so that you can see the inside of the back of your mouth. Intone a long aah. You will see the action of the palate rising, because the aah is a sound with oral air release, so the palate will move up to close off any nasal air escape. You can see it in this vowel because the tongue is both back and lowered; if you change the vowel to ee, oo or or, the tongue will block your view of the palate. If you change the aah resonance, giving it a nasalised quality, the soft palate rises against the back wall of the nasopharynx but the tongue moves back with it, so that you will not actually be able to see your palate.

Soft palate 3: To become aware of soft palate movement: feeling the oral–nasal contrast See if you can feel the movement as you change from an oral aah (all the air comes out of the mouth) into nasalised aah (some of the sound comes out of the nose), and then into a long nasal ng sound (all the air comes out of the nose). Do this several times. Close your eyes and focus on the sensation. If you block your ears with your fingers, you will be able to hear a very clear difference in resonance.

Soft palate 4: To become aware of soft palate movement: feeling the difference in air escape Place your hand flat just under your nose, palm facing the floor. Intone a long mmm, and you should a slight warmth from the air on the top of your hand. If you then intone a long aah, this feeling will go. SLTs have long used this kind of exercise with a mirror instead of a hand; the long mmm will make the mirror mist up.

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Soft palate 5: Moving the soft palate: voicing on ng and aah Feel the soft palate movement as you move from intoning a long ng sound, into a long aah. Do it several times. Make sure that the aah is fully oral in its sound. Close your eyes and focus on the sensation. If you then make the aah slightly nasalised, you may feel less movement of the soft palate; this is because air is now escaping though both your nose and your mouth.

Soft palate 6: Checking for nasal air escape: nose holding This is one of the oldest and simplest exercises to tune a client into the different exits for sound vibrations, and to enable him to explore his own pattern of soft palate involvement. Hum on a long mmm and, while it is happening, pinch your nostrils with your thumb and finger to close them. Of course the air and sound will be stopped. Release the nostrils, and now intone a long aah. Again pinch your nostrils and you should hear no change in the voice quality. Now see what happens when you make a long nasalised aah, with a deliberately rather unpleasant sounding nasal resonance. Several times pinch and release your nostrils, and see how the sound changes but does not actually stop. Once a client has got the idea of this, you can ask him to read or repeat a number of words that have no nasal sounds in them (m, n or ng), exploring whether they are affected by the nose holding.

Soft palate 7: Awareness of the soft palate: tongue–palate contact on g (An exercise adapted from Cicely Berry 1994.) With a loose, slightly open jaw setting, say a strong guh sound several times using significant pressure and tension. Feel the contact of the back of the tongue with the palate. Then release that tension but say guh several times again, firmly and with awareness of the contact, but without that strong tension. Intone an open aah sound, sensing that the soft palate is raised and ‘out of the way’ so that there is a good echoing space in your mouth.

Soft palate 8: Moving the soft palate: kaya gaya and other sounds Just as in the ge sound above, make a deliberately tense contact between back of tongue and soft palate as you call kaya! gaya! Hold the closure in your mouth for a second or two before you release the sound out. Repeat several times. Then play with the sounds guh kuh nngaaa.

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In ‘playing sounds’ we might chant them over and over again, sing them up and down a scale or to a well-known tune, speak them out loud in a string of emotional gibberish, and generally explore their sound and feeling. Rather than setting aside a special time for voice exercises, such sound exploration is often best done as part of an ordinary solitary activity.

Pharyngeal/Laryngeal area Excess constriction in the pharyngeal and laryngeal area do not always go together and, when separate, they do sound different in a speaker or singer. However, freeing up work for both shares a number of exercises, hence their grouping in this section. For simplicity of expression, the text of the exercises refers to the pharyngeal/laryngeal settings as the ‘throat’.

Pharyngeal/Laryngeal 1: To help release excess muscle tension: self-massage Place the flat of your right hand on the left side of your neck and rub up and down the length of that big side-of-neck muscle, the sternocleidomastoid, from just behind your ear down to the join with your shoulder. Gently knead the muscle between your thumb and fingers, letting your jaw drop as you do this, and keeping the tongue flat and forward in your mouth. Repeat, with left hand on right side of neck. Then place your right hand on the right side of the back of your neck (i.e. not crossing over your body) and massage the back of your neck, rubbing as hard as you feel is comfortable and helpful, with your fingers moving up onto the back of your head. Repeat the sequence, with your left hand.

Pharyngeal/Laryngeal 2: To create an awareness of pharyngeal tension: conscious constriction Pull the tongue back, deliberately tighten the back of the mouth area and say ‘aaa’, listening for a tight, restricted sound. The tongue will inevitably be tense but try not to over-tighten in the jaw or laryngeal muscles. Count 1 to 10 out loud in this voice, or say the days of the week or the months of the year. You are aiming for a quality to which words such as ‘backed, dark, tight’ might be applied. (Comedian actor Rowan Atkinson’s character ‘Mr Bean’ has this kind of channel constriction.)

Pharyngeal/Laryngeal 3: To create an awareness of laryngeal tension: conscious constriction Imagine having to lift something heavy and let the breath catch in your throat as you tighten your laryngeal area. Now squeeze some sound through that narrowing. First of all say ‘aah’,

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and then count 1 to 10 out loud in that very constricted voice. Then ease it up so that it is not quite so squeezed, but keep that awareness of what it means to have too much laryngeal constriction. Inevitably the vocal fold vibration will be affected so that you may sound rougher or more breathy; you will certainly sound strained!

Pharyngeal/Laryngeal 4: To create an awareness of constriction: fingers in ears Block your ears with your fingers and breathe in and out. If your throat is unconstricted, you will hear very little sound in your ears. If you then deliberately tighten the throat area, you will be able to hear air turbulence as the breath comes in. Still with your fingers in your ears, move from tight and constricted to open and silent.

Pharyngeal/Laryngeal 5: To create an awareness of constriction: breathing on the hand Hold the palm of one hand close to your mouth. Breathe out onto it with a tight constricted throat, mouth quite wide open. You may feel the breath only on a small area of your palm. Then ‘open’ the throat, keep the same mouth position, and you may feel the warm air on a larger area.

Pharyngeal/Laryngeal 6: To feel the larynx rise and lower: swallow, yawn and pitch slide Show the client how to lightly put a finger on the part of the larynx that most sticks out. Ask her to swallow and then yawn. She should feel the larynx move; if not, you can discuss why. Then ask her to ‘slide’ gently up and down her pitch range on a long eee sound. Talk about whether she feels laryngeal movement, and whether you see any.

Pharyngeal/Laryngeal 7: To encourage the larynx to drop to a lower than usual position: gentle rubbing If a client’s larynx is habitually held too high (too low is less common), you can stand behind him, softly place the fingers of each hand either side of his larynx, and very gently rub downwards to encourage the muscles to lengthen a little and the larynx to move slightly downwards. Only rub at the sides, not at the front. The structures and sensation in this area are very delicate, so this needs to be done with great care; if in doubt, do not do this.

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Pharyngeal/Laryngeal 8: To allow the throat to widen: the ‘happy-yawn shape’ for silent in-breath and out-breath Any use of a ‘pretend’ yawn posture in exercises should be done with the tongue consciously kept in a forward position, tongue tip touching behind the lower teeth. There are many variations on this exercise with different names; singing teacher Janice Chapman (2006) refers to the ‘pre-yawn’. Make a silent aah shape at the back of your mouth as air enters your lungs, and feel an expansion in the lower ribs or abdominal area. Imagine a feeling of great delight as the back of your mouth widens in an internal smile; your lips do not need to spread but your tongue will, and your cheekbones will feel as if they are lifting. As this happens, the back of the mouth widens. If you lightly place your fingers and thumb above the larynx, you may feel a widening of the vocal tract and a lowering of the larynx position. Then release the breath, keeping that same internal posture. There should be only very slight breath noise as the air enters and leaves you, or none at all. Repeat several times.

Pharyngeal/Laryngeal 9: To release constriction: the whispered ‘haa’ (This is based on the Alexander Technique whispered ‘ah’, described by Glynn Macdonald (1994).) Ask the client to sigh out on a deep audible sigh of relief. (This should be voiceless, not the voiced groan.) Listen to the quality of the sound as the air passes through the throat – does it sound tight or open? Demonstrate the difference between tight and open throats; I generally produce a ‘bad-tempered’ tense sigh, followed by a relaxed, open sigh, so that the client can hear the change. Ask her to imagine something that makes her feel irritable, and to make that tense sigh. Then ask her to imagine a feeling of great relief and pleasure, and again to sigh. (The sighs of some clients sound almost identical whether they think relaxed or tense.) Introduce the idea that the tension of a ‘whispered haa’ sigh can be graded on a 1–10 imaginary closed throat/open throat scale. Demonstrate a very constricted grade 10 haa, and then a very open, relaxed haa; call this grade 1. Make sure that the latter sound is audible; there should still be the sound of the air passing through vocal folds and pharynx, but it is a warm, low, open sound with very slight friction, rather than a tight ‘sandpaper’ type of sound with a perceived higher pitch. As the vocal folds are not actually closing, there is no true pitch, but the narrowed space on the throat produces a higher sound than the wider space. Ask the client to produce a range of deliberate haa sigh sounds, as you give her different numbers with varying tension settings on the scale. Obviously you are working towards her being able to produce the much lower numbers without constriction. Learning to identify and deconstrict in the voiceless sigh can be an important precursor to work on released voicing; if our throats are tight even as breath passes through, they are certainly likely to be constricted once we start the action of vocal fold vibration.

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Pharyngeal/Laryngeal 10: To release constriction: whispered ‘haa’ into voice Once a client has managed to control the tension settings of the whispered haa, he can be asked to ‘sneak in’ voice. He makes an open whispered haa and moves as seamlessly as possible into voicing it, with no extra tension or effort. It should go from whisper through breathy onset into smooth fill phonation. It is useful for those with a tendency to ‘squeeze or bash’ as they go into voice; through the whispered haa they have learnt to monitor laryngeal tension, and can begin to explore balanced phonation tension. It may, however, take some time to become smooth and easy.

Pharyngeal/Laryngeal 11: To release constriction: the yawn-sigh This is similar to exercise 8 but the instructions have a different emphasis. Boone and MacFarlane (1993) found that it was useful in ‘lowering the position of the larynx, widening the supraglottal airway, and producing a more relaxed voice’. Drop your jaw open, keeping the tongue tip behind your lower teeth and the tongue body flat. Imagine the feeling of a ‘lift’ in the soft palate, stretching and widening the back of your mouth. Let a voiceless sigh come through the wide space of your vocal tract, as in a pretend yawn (it may precipitate a real yawn). Repeat several times. Then make several yawn–sigh postures in a quiet, effortless voice with the pitch sliding downwards. Use this ‘wide-open’ throat posture in words and sentences. Some clients need to begin with words that start with /h/ because this helps prevent excess tension; make sure that this does not become a tight pushed whisper. Once smooth onset is established, then move into words that begin with a vowel: heavy, healing, house, hoping, harm, arm, easy, awful, amble, ease, oddity, arrow etc. How heavy is Harry’s hog? Who is having ham at home? etc.

Martin and Darnley (1992) and Boone and Wiley (2000) have a good selection of such phrases. However, it is good to get willing clients (particularly children) to make up their own, because these will come from a personal vocabulary and usage, and are more likely to act as reminder triggers in ordinary talking.

Pharyngeal/Laryngeal 12: To release constriction: the sighed eee Pershall and Boone (1985) used computed tomography (CT) scans of patients’ necks and found that ‘the sighed eee produced the most maximally dilated pharynx of all tasks performed’. Yawn–sigh, with and without voice, on the sound eee.

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Pharyngeal/Laryngeal 13: To release constriction: the closed-mouth yawn This silent or ‘socially appropriate’ yawn can be done in public, as a quick release. Keep your lips closed, drop your jaw slightly, make the stretch of the yawn shape movement at the back of your mouth, and feel the pharynx stretch open and the larynx drop slightly.

Pharyngeal/Laryngeal 14: To release constriction: the yawn–groan Once you have the posture and feeling of the open yawn–sigh, make a continuously voiced aah in the manner of a deep groan. First do it on one intoned pitch, then let the note fall in pitch, then rise and fall. I suggest to clients that it is the kind of sound that they would make if playing the role of a gloomy, echoing-voiced ghost in a local pantomime.

Pharyngeal/Laryngeal 15: To release constriction: the dentist’s chair (From singing teacher Jenevora Williams.) Put your head and mouth in the position that you would need to take if a dentist were to examine your teeth, i.e. head tipped slightly back, mouth wide open and tongue protruded. Try to swallow – you can’t in this position. Intone or sing a few rather uncomfortable notes moving from low to high. Then gradually bring your head to an upright position, return the jaw to a loose but not protruded position and bring the tongue fully back behind the lower teeth. Repeat the sounds while maintaining that sense of the open throat.

Pharyngeal/Laryngeal 16: To release constriction: awareness and reduction of ‘audible gasps’ Some speakers use a habitual pattern of audible tight throat inspiration as they breathe in, and it is as important to reduce this feature as it is to work on constriction in voicing. Audible gasps often occur in muscle tension voice disorders, but can also be a problem for some actors, singers and broadcasters. Audio recordings of a client chatting conversationally ‘in full flow’ can alert her to this habit, as does this exercise. Ask the client to count quickly and quite loudly up to 100, taking a quick breath whenever she needs. You can both attend to whether the in-breath has audible tension. If so, she should repeat the sequence, trying to let the breath come in through a consciously controlled relaxed and open throat, with flattened tongue in forward setting. Then ask the speaker to take a simple sentence such as ‘I’m talking’ and to repeat it quickly at least 10 times. She should let a breath drop in after each phrase, and work to consciously control any tendency to constrict. If difficult, suggest that she reads aloud with alternate sentences tight throated and open throated, and then only the open.

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Pharyngeal/laryngeal 17: To release constriction: ‘plummy voice’ The idea of a plummy voice originates in a listener’s unconscious auditory impression that a speaker has so much space at the back of his mouth that a plum could (in theory) fit there. (Kathleen Ferrier’s throat was described as so commodious that it could accommodate an apple!) It has come to be associated with a posh accent, but actually has much more to do with a resonant quality. Using a ‘plum’ image can encourage a speaker to lower the larynx and widen the pharynx; similar to many ‘as if’ exercises, once the feeling and sound have been achieved, the activity is lessened to create a slight sense of widening and deconstriction. Ask the client to copy you doing a very ‘plummy’ voice on some simple counting. Encourage the speaker to use his own regional accent, but with an ‘echoing plum space’ resonance. After a while, change the plum image into a cherry, and finally into a simple awareness of the potential space.

Pharyngeal/Laryngeal 18: To release constriction: ear popping Silently drop your jaw and see if you can consciously stretch the back of the pharynx enough to make your ears ‘pop’ or ‘creak’. It does not matter if they don’t; the point is to get the same stretch gesture happening that could lead to ear popping.

Pharyngeal/Laryngeal 19: To release constriction: the little laugh The laugh and pretend cry voice have long been used in voice exercises, but Jo Estill’s work formalised these techniques and gave many voice practitioners their first opportunity to see in her videos the widening effect of the giggle and sob on the pharyngeal and laryngeal areas. Let the jaw open to around a one-finger drop. Feel a widening at the back of your mouth, keep the tongue flat and make a very quiet little laugh. Then make this same internal posture in silence.

Pharyngeal/Laryngeal 20: To release constriction: the operatic laugh and the operatic sob With relaxed lips and jaw, and a wide aah vowel posture, laugh down and then up your pitch range in a quiet ‘operatic’ quality manner. Then do the same thing in a quiet, melodramatic sob. If you put your fingers under your chin, just above the larynx, you may feel the channel widening, and the larynx lowering as you come down in pitch.

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Whole channel work To release constriction: the ‘natural sounds’ These are based on James d’Angelo’s (2000) sequence. He describes these sounds as releasing for body, voice and emotion. They are similar to the concept of ‘primal’ sounds as used by Chapman (2006), Linklater (2006) and others. I demonstrate and teach these to some individual clients as a release sequence, but only if the person is open to the in-depth solitary sound self-exploration required. They are more frequently incorporated as part of a group workshop, where they are explored in both movement and voice. All the terms except, possibly the ‘keen’, will be familiar to voice practitioners. D’Angelo says this word originated in Ireland, and is like a downward sliding wailing sound. Sigh – voiceless and then with voice. Yawn – voiceless and then with voice. Sob – quiet and melodramatic. Groan – big and echoing. Keen – gliding down the pitch range on a vowel, and then gliding up. Laugh – down and up pitch range. Yell – strong breath support and open throat. Hum – lips tingling – one note and then sliding up and down.

Chapter 21

Phonation voice exercises

The free voice has phonation that will vary appropriately according to mood and energy but is not excessively rough, breathy, creaky, weak or strained. What we hear in phonation is inextricably interlinked with what happens in the other voice aspects, particularly channel, pitch and loudness; direct work on these areas often changes phonation quality. We work to release tight pharyngeal and laryngeal muscles, and hard vocal fold onset or rough phonation quality is consequently reduced. Pitch changes are made by alterations in vocal fold length and tension, and so pitch work affects phonation settings. The rough and breathy quality of vocal nodules may be an inevitable result of a change in vocal fold shape, but, as work improves voice production, the nodules diminish and the phonation quality improves. There are fewer options for direct exercises that move or shape the false and true vocal folds themselves, but their movement is affected by many other practices. Courses run by practitioners of the original Estill Voice Training System offer a wide range of specific and highly refined techniques to develop awareness and control of these and other vocal tract structures. So too do the independent companies Voice Craft and Vocal Process. The Voice Skills approach focuses on five main phonation issues that can be vocal problem areas: excess tension, roughness, breathiness, creak and phonatory stamina. The exercises below relate to these aspects. As with other exercises, they are generally addressed to ‘you’, so you model the sound and the client copies you; appropriate discussion of how the sound is made can accompany the ‘doing’. Many phonation exercises aim to increase awareness of the sounds that the folds can make. Once a client recognises contrasts, she is more able – with guidance – to alter any negative patterns, and practise new phonation qualities in ordinary talking or singing. ‘Balanced’ phonation quality refers to an absence of roughness, breathiness, creak or strain.

Phonation 1: To feel the larynx get ready for voicing: fingertip touch Place a thumb tip on one side of the larynx, and the four fingertips on the other side. Imagine that you are just about to make a long aah sound, and silently shape the moment before

Voice Work: Art and Science in Changing Voices. Christina Shewell © 2009 Christina Shewell. ISBN: 978-0-470-01992-4

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you would move into voice. Even though no sound is made, you will probably feel a change under your fingertips as the larynx slightly moves; within it, the vocal folds are preparing to voice by moving into a ‘pre-phonatory’ setting. You can sometimes feel slight movements if you silently ‘sing’ through a song on a vowel sound.

Phonation 2: To feel the vibration of the vocal folds: finger on space between thyroid and cricoid cartilages This can be an interesting ‘tune in’ for clients, who may feel for the first time that there is indeed something that vibrates in the neck. Place your finger on the hollow between your thyroid and cricoid cartilages, and show the client how to do the same (Figure 21.1). Demonstrate how he can feel a vibration as he hums. (If the ‘cricothyroid visor’ – see Lieberman (1998) – is locked in a closed position, it will be difficult to feel the hollow between the two larger laryngeal cartilages.) Clients may then still feel vibrations if they place the fingertips somewhere else on the larynx.

Figure 21.1 Finger on space between thyroid and cricoid cartilages.

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Phonation 3: To feel the thyroid cartilage tilt forward on the cricoid cartilage: squeaking and creaking Place a finger at the front of your larynx; see if you can identify the little hollow between the thyroid and the cricoid cartilages. Do a high-pitched whimper, like a dog, and feel the larynx rise slightly and the gap between the cartilages close. Now make a medium-pitched creaky sound, and there will be much less or no movement. Make some different sounds and explore what happens.

Phonation 4: To encourage false vocal fold opening: silent yawn sniffing When we sniff, the true and false vocal folds usually open widely. Sniff air in through your nostrils, at the same time making a shape at the back of your mouth like a wide, smiling yawn.

Phonation 5: To discourage excessive inward false vocal fold movement: inspiration phonation Laryngeal endoscopy may show that a client’s false folds regularly move across to the midline, adding to laryngeal constriction. In rare cases a client’s voice is produced with false fold vibrations. Ask the client to sniff loudly to get the feel of inspired air. Then ask him to make a quick, voiceless gasping intake of breath through the mouth, as if he heard something shocking. Repeat this several times. Now ask the client to voice this sound, like someone gasping for breath on a vowel sound such as aah. Ensure that it is not done with too much tight throat closure. Then see if he can make that voiced sound on the in-breath (ingressive air stream) and then immediately on the out-breath (egressive air stream). It is not a ‘comfortable’ sound, and can be quite drying for the throat, but is often an effective short-term device to get the true folds working again. Repeat several times. Then ask him to count from 1 to 10 out loud, using both in-breath and out-breath voice for each number. Then, quickly, on outbreath alone. If this works, move into a series of sounds, words and phrases until easy true vocal fold voice is established.

Phonation 6: To discourage excessive inward false vocal fold movement: the operatic laugh Jo Estill’s videos of the vocal tract in action during voicing showed that certain deconstriction techniques could encourage the false folds to ‘get out of the way’. This exercise is inspired by her ‘giggle’ exercise.

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Make a very quiet laugh on ha ha from medium high to medium low in your pitch range as if you were a rather melodramatic opera singer.

Phonation 7: To help hear phonation quality more clearly: voice against wall Stand in front of a wall in a quiet room, close enough to put your elbows onto it at face height. Cup one hand behind an ear, with your fingers slightly pulling it forward. Place the other hand at the side of your face, abutting the wall (Figure 21.2). Direct your voice against the wall as you hum, and intone some long vowels, and then words or sentences. You will hear the sound ‘bounce back’ at you, and should hear your own sound more clearly.

Figure 21.2 Voicing against a wall.

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Phonation 8: To help hear phonation quality more clearly: hands cupped around ear and mouth Place the thumb side of your left hand just behind your left ear, in a curved ‘cup’ shape. Place the palm of your right hand an inch or two in front of your mouth, with its base touching your chin. Slightly angle it towards your left ear. As you voice, the sound should ‘bounce’ off your right palm onto your left and so into your ear.

Phonation 9: To move through different vocal fold tension settings: wicked witch into breathy seducer This is done on one breath. Start by making a tight ‘wicked witch’ sound, with hard onset with creaky and rough quality on a long intoned aah. Gradually release the excess tension so that the sound develops a balanced phonation quality. Then move this into a too-breathy sound. (This quality is sometimes considered to have ‘seductive’ tone.) You can point out the different qualities to a client as she moves through them, including the moment when there is exactly the right tension and closure for balanced phonation quality.

Phonation 10: To release excess laryngeal tension: breathy ‘sweet baby’ sound This is so called because it is the sound that some people make in response to something little and ‘sweet’ or ‘cute’; it is a downward gliding rather than a breathy ‘aah’.

Phonation 11: To release excess laryngeal tension: glide into creak Creak is damaging to the voice only if made with excess constriction with low subglottic air pressure. Some singing teachers call this exercise ‘clearing the cords’, and consider it a useful loosening technique. McKinney (1994) says that learning to imitate vocal fry (creak) can help singers release tension that is limiting the production of lower notes. Start a glide on eeh at the top of your pitch range and slide it down to the bottom of your range, where you allow it to become comfortably creaky.

Phonation 12: To reduce rough or tense phonation quality: confidential voice This is designed to encourage gentle vocal fold closure to reduce excess compression as the folds close.

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Speak quietly but firmly, as if you are discussing something secret with another person and do not want to be overheard. There can be a slightly increased breathy quality and speakers should be encouraged to use quite extensive lip movements, to take pressure off the laryngeal area.

Phonation 13: To reduce end-of-sentence creak Some speakers have a regular creak quality as they approach the ends of sentences. Mild versions are normal but, if excessive, the creak may be a contributor to vocal fold health problems, or inappropriate for the speaker’s voice. Such a pattern can happen if subglottic air pressure drops as the person runs out of breath in long sentences, and breath work will be needed. However, it sometimes occurs as a habit – the speaker ‘bunches’ up the folds and moves into a creak. Record the speaker and let her hear the sound and the pattern in the playback. Once identified, use negative practice in a number of sentences – alternately deliberately creaking and then finishing the sentence with no creak quality. When a speaker has a vocal fold paralysed in the open position the sound is often breathy. Exercises 14–21 can also be used to encourage the best possible vocal fold closure.

Phonation 14: To contrast breathy with balanced phonation quality: ‘sneaking in the voice’ Make a long whispered (no voice) haa, move it into breathy phonation and gradually move into balanced phonation quality, with no excessive vocal fold tension. This exercise also appears as pharyngeal/laryngeal exercise 10 in Chapter 20.

Phonation 15: To encourage vocal fold closure and to reduce breathy phonation quality: ‘glottal pops’ Let the jaw move into a relaxed one finger-drop position. Breathe normally. Then, on an out-breath, see if you can quietly stop the flow out by a gentle closure in your vocal folds, and do several as the breath flows out. You may hear a quiet ‘pop’-type noise – a very tiny voiceless ‘uh’ sound. This should not be done with excess tension. If a client finds it difficult to get the idea of this, ask her to deliberately close the folds in an over-tense way, imagining that she is lifting or pushing something heavy. She should then greatly reduce this pressure, so that there is a very soft closure. Ask her to make several of these quiet stops on one out-breath and to feel what is happening. If she places her fingertips and thumb tips around the larynx, she may feel a slight movement in, like that which occurs when we silently signal in conversation that we want to speak.

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Phonation 16: To encourage vocal fold closure and to reduce breathy phonation quality: staccato sounds On one breath and one pitch make a series of quick staccato (separate) sounds on hih. Then move up and down in pitch with those staccato sounds.

Phonation 17: To reduce breathy quality: strong /b/ Make the articulatory closure for /b/ but do not immediately speak this. Let strong pressure build behind the lips before the sound is released – bah bah. Take this into words that begin with /b/. There should be no excessive loudness; the idea is that the vocal energy comes from strong vocal fold closure, not high volume.

Phonation 18: To reduce breathy quality: vowels as darts Make an uh uh sound with deliberate hard onset. Use the image that you are throwing the sound like a dart, to different places in the room. Then do the same thing on other vowel sounds.

Phonation 19: To reduce breathy quality: ‘karate’ sounds Use some strong punching movements as you say hey! ho! hah! yeh! yoh! in a mock karate manner.

Phonation 20: To encourage vocal fold closure and to reduce breathy quality: pushing This is a traditional voice therapy technique in cases of vocal fold paralysis, and aims to help one vocal fold compensate for a weak one. It needs to be done well to avoid negative excess tension in the whole body and vocal tract. Actors sometimes use the ‘push’ to connect to lower support and reduce any tendency to be ‘off the voice’ (breathy voice or thin folds). One technique is to place the hands flat on a wall and lean the body weight against it, as a strong ‘uh’ is produced. Lean your body weight against a wall and push out a sound through tightly closed vocal folds; then make the sound without the leaning. Or, sitting on a chair, place your hands flat on its seat and lift yourself up by pushing downwards, at the same time letting a sound come out on a strong uh.

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Phonation 21: To encourage vocal fold closure and reduce breathy quality: quiet throat clearing This kind of exercise can be useful in voice therapy to help a person ‘refind’ her voice after a period of emotionally linked complete voice loss (aphonia). Ask the client to quietly clear her throat a few times. If you can hear a voiced sound, the vocal folds are closing. You can see if she can move this into a quiet mm sound, and then into a vowel.

Phonation 22: To reduce breathy quality: deliberate creak Make some creaky noises on vowel sounds. These noises need to be as relaxed as possible, so there must be no sense of laryngeal squeeze. Slide up and down in pitch. Then intone a creaky vowel and smoothly move it into a vowel with no creaky quality. Once you have found an easy, unconstricted creak, use it to speak in a quiet ‘spooky’ tone of voice (named the ‘creaky ghost’ voice by 9-year-old Josh, whose story is in Chapter 27). Then move into balanced phonation quality, aiming to have no excess creak, roughness or breathy quality.

Phonation 23: To explore thin fold–thick fold: contrasting sounds These can be useful as a precursor to work on reducing roughness or creak: • Contrast the sound of a whimpering dog with a strong hey call. • Contrast the ‘thoughtful’ downward sliding considerate mm with a strong hum. • Contrast a high pathetic moan with a deep chuckle.

Phonation 24: To reduce rough phonation quality: humming Harris et al (1998) explain that in humming there is ‘minimal involvement of the vocal tract beyond closing the lips’, and that the position of the vocal folds resembles an extension of that seen in quiet breathing. In other words, it produces the maximum possible ‘easy voice’. Do a gentle mm mm, as if you were comfortably agreeing with what someone says. Then take this into a longer intoned sound. Make this at different pitches. Take into mm plus different vowel combinations (see the ‘figure of eight’ exercise in Figure 22.1).

Phonation 25: To reduce rough phonation quality and encourage forward placing: babbling Let your voice come out on a stream of easy improvised bilabial (m, b, p) consonants and vowels, rising and falling in pitch and volume.

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Phonation 26: To practise balanced phonation quality: glides and sirens • Start an ng sound at the bottom of your pitch range and then scoop, slide or glide it up to the highest note that you can make. Do the same on an eeh or ooh sound. • Then slide from bottom to top, and back down to bottom again. Repeat several times. • Do this again, more slowly, several times. • Do a siren, a sound on eeh or ooh that scoops up and down, several times on one breath. • Then alternate between a low and a high note and back a few times, on one breath. Check that you are not changing your head and neck alignment as you do this.

Phonation 27: To practise balanced phonation quality: humming and toning improvisation Sit or stand in a comfortable position. Let the breath deepen and settle. Hum a deep and very long sound. Let that hum move up and down in pitch and, after a while, open it up into vowel sounds. Simply let the sound ‘go’ anywhere you like in your pitch range – but keep the quality as smooth as possible.

Phonation 28: To practise balanced phonation quality: intoning talk and chant talk Speak about something, first of all intoning all the words on one pitch, and then moving between pitches in ‘chant talk’ – where each word or syllable is slightly prolonged and varies in pitch placement.

Phonation 29: To improve phonatory stamina: ‘build up’ ideas It is impossible to simulate the vocal demands of workplace or performance within a voice session. Once we have worked out why a client’s voice deteriorates over time, we can tailor make stamina exercises, which should be done only when body, breath and channel are all working well to support any vigorous vocal work. These ideas are based on physical exercise training principles, and are designed to be incorporated into someone’s day to build both facility and confidence at avoiding vocal fatigue. We can point out that it’s like being at a ‘vocal gym’. • Count 1 to 20 twenty times while standing and then walking round the room with conscious abdominal support and balanced phonation quality. Then do this again, repeat – doing five quietly, five with medium loudness, five loud and five very loud. • Repeatedly make an intoned aah at three loudness levels (high, mid and low). Prolong each for 10 seconds (or as long as the client can comfortably manage). To start with,

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suggest that this sequence is done in groups of five repetitions, and see how that feels and sounds. The aim is to avoid any misuse of body posture, laryngeal tension or any other aspect of voice that could contribute to vocal fatigue. If five repetitions are easy, suggest that the client does groups of seven and then ten. They can be spaced throughout a day, and the total number of times can be discussed. • Repeated quiet scales on yeh – all starting on the same comfortable start pitch. Repeat 10 times, then gradually increase to a maximum of 50 times. • Take a simple song and sing it several times over, varying the volume levels of different lines, or start soft and build to a dramatic climax!

Phonation 30: To maximise healing in vocal fold condition: voice rest handout This is an example of the kind of handout that might be given to clients who need to have a short period of complete vocal silence. The theoretical background is described in Chapter 16. Complete silence can help healing of the delicate surface of the vocal folds to take place as the vocal folds vibrate during voicing. When you consider that a man’s vocal folds are opening and closing an average of 100 times a second, and around 200 times a second or more for a woman, it may be clear why a period of relative inaction can be helpful. Voice rest may refer to one or both of these choices: 1. A period of complete silence, with absolutely no talking, whispering or singing, and the minimum possible throat clearing and coughing. 2. Not taking your voice into noisy environments, not shouting, not talking all day long, allowing some periods of silence during a day, avoiding late nights and noisy evenings, etc. Our advice is that for a short time (to be agreed with your ENT surgeon or speech and language therapist) you follow the first meaning of complete silence, and then the second meaning of general voice care for at least a week afterwards. The first stage can be quite difficult, so DO: 1. Alert your friends and family, so that they will support you. 2. Record an answer phone message for your phone, which makes it clear that you will not be able to phone people for some while. 3. Get in a stock of good books, videos, DVDs and/or work. 4. Try to stay at home if you can. Other than a walk where you will meet no one with whom you have to speak, you should not go out. Shopping generally means speaking! 5. Have a notebook and pen by you at all times – to write what you want to say. 6. Accept that it will be difficult at times – but try to persevere. If you break the silence once or twice, it is still worth continuing. 7. In any emergency – of course you can speak! DO NOT talk, whisper or sing – and try to avoid any throat clearing, coughing or voicing of any kind, unless really necessary. Also avoid lifting or pushing anything with effort, as the vocal folds have to tightly close when we do these actions.

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After a day or two of complete silence, some people’s voices may sound worse before they sound better, as if they are slightly ‘rusty’. The first sounds you make should be some gentle humming on mmm; try a steady note and then up and down your pitch. Then do some quiet counting, days of the week and months of the year, before you go into chatting in a quiet ordinary voice. On the first day when you start to speak again, don’t undo the rest by making up for lost time. Talk more quietly and much less than usual. For the following week, speak more quietly than usual, and avoid any situation where you have to raise your voice. Take extra care of your voice for 4 weeks or so. Avoid noisy environments, keep your voice volume down and do not expect your voice to be as strong or resilient as usual. It will need looking after! Call your doctor, or the speech and language department, if you have any queries – or ask someone to do that for you if you are in the midst of the silent period.

Chapter 22

Resonance voice exercises

The free voice has an appropriate balance of head, oral and chest resonance qualities with an appropriate sound of forward ‘placing’ in the mouth.

Resonance 1: To prepare the body for resonance work: rubbing, shaking, jiggling and jumping Many of the loosening exercises described in Chapter 18 are useful preparation for resonance work. Jumping up and down while letting out a long aah sound can help to loosen both body and sound; it can feel as if the resonance drops down into the body. It often makes people laugh, which is an added bonus, because the throat then opens and there is more space for resonance. For those whose fitness prevents them from jumping, the ‘chair bottom bounce’ can be used. Ask the person to sit only half-on a chair seat, but with bent legs strong, and feet firmly connected to the floor. He should start intoning a long aah sound and at the same time push up and down on his legs so that his bottom is slightly lifted up and down off the chair; the resulting sound will be jerky and usually with quite deep resonant qualities. (The voice work of Catherine Fitzmaurice, well known in the USA, incorporates a highly specialised form of shaking; her Tremorwork™ is used as part of what she calls ‘destructuring’ which promotes body awareness, spontaneous free breathing and vocal expressivity, before the second phase of ‘restructuring’.)

Resonance 2: To tune into the sensation of head resonance quality: hands-on humming and vowels Rub your hands over the top and back of your head, your forehead, cheekbones and nose and, as you do so, start to hum quite a strong mmm. Keep your tongue up high against the

Voice Work: Art and Science in Changing Voices. Christina Shewell © 2009 Christina Shewell. ISBN: 978-0-470-01992-4

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roof of your mouth and feel that although the air and sound vibrations are coming out of your nose, the sound can also be felt as if reverberating around inside your head. Picture it going into the top and back of your head, your forehead, cheekbones and nose; at moments you may even feel a sense of vibration under your fingers. After a minute or so, move into intoning different vowels aah, eeh, ooh, again imagining the sound around your head.

Resonance 3: To access and practise producing strong head resonance quality: chewing the drone Prolong a long and nasal mmm in a long ‘drone’. Keep your lips closed but chew and move your lips, tongue, jaw and facial muscles around to hear changes in the sound. If you place your fingers in your ears, you will hear the changes in a different way.

Resonance 4: To explore head resonance quality altered by lip and mouth shaping together: the nasal murmur Start to make a long nasalised nng drone, and let the sound come strongly out of your nose. Keep a firm tone in your lip muscles as you move them between ooh sound and a waah sound – ooh–waah–ooh–waah–ooh–waah. You may hear some harmonics as you do this.

Resonance 5: To access and practise producing strong head resonance quality: calling king king (Exercise from Grotowski 1975.) Call king king, loudly and strongly, placing it as if high in your head resonance area. Move into calling king kong, lots of times, and then try some other sounds that contain /g/ /k/ and /ng/ sounds.

Resonance 6: To narrow the epilarynx: exploring the twang or ring Chant the ‘irritating child taunt’ – nyaah nyaah nya nyaah nyaah – and explore this for a while. Feel the power of this and find ways to utilise in the singing voice. In a mock country and western quality, sing My mamma sewed sheets down in Tennessee. See if you can make this quality first with nasal tone, and then without. Kayes (2000) describes how cackling like a happy witch, cat yowls and excited duck quacks also activate the twang.

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Resonance 7: To access and practise producing excess head resonance quality: speech (You may do these tasks with extra nasal resonance or with the ring quality; for this exercise it does not matter. Just listen to the sound and see if it would carry well without strain.) Still with that sense of extra head resonance, intone no, no, no and yes, yes, yes and why, why, why and where, where, where, all the time keeping that clear head-resonant quality. Count out loud from 1 to 20, and then the days and months with the same resonance. Speak these sentences with excess head resonance: He’s a mean little man who needs to mind his manners. My mother must make more marmalade on Mondays. Minced meat never seems to minimise my migraines.

(Make up some more of your own, containing lots of /m/ /n/ and /ng/ nasal sounds.)

Resonance 8: To access and practise producing slightly increasing head resonance quality: in speech Modify the head resonance, so it has less whine or twang, but still has more ‘head-bright clarity’ than usual. Repeat the spoken exercises, and then speak a nursery rhyme or other text with that extra resonance. Then speak any sentence of your own thoughts, or tell a story. You can encourage a client to use some ‘real-life phrases’ with this new experience of head resonance. A junior schoolteacher practised with phrases such as ‘can you please sit down’ and ‘be quiet’, while a policeman produced a strongly ringing ‘stop right where you are – NOW!’. Sociable young women can practise ‘I’d like a white wine’ so that their voices can safely carry across a noisy club to friends at the bar!

Resonance 9: To tune into oral resonance quality: the vowel resonator scale Who would know aught of art must learn and then take his ease.

This sentence has long been used as illustration of the vowel ‘resonator scale’. If you whisper all the words, and then whisper the vowels in it alone, you will hear that they seem to rise in pitch, even though there is no voice. The shape of the mouth and pharynx changes for each vowel, producing a series of different vowel formants that seem to rise in pitch. Speak this sentence quietly, with a clear focus on feeling those vowel shapes ‘resounding’ in your mouth.

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Resonance 10: To tune into oral resonance quality: energetic consonant work As most speech sounds are produced by moving the mouth and pharynx, energetic articulation exercises also increase awareness of the oral resonance spaces. Strings of consonants with very precise, energetic articulation can be repeated on different rhythms, and then coupled to vowels; examples of this are given in Chapter 25. These need not all be from your own language; in many African languages clicks are part of the ordinary sound system. Explore all the different clicks possible in your mouth – lip-smacking ‘kiss’ sounds, tongue-tip tsk, lateral ‘gee-up horse’ sounds and guttural voiceless kuh. Feel the strength of your articulation and how the vocal noises move within your mouth.

Resonance 11: To access and practise producing ‘forward-in-the-mouth’ placing: the lip tickle Lick your lips, teeth and inside of mouth. Hum a long mmm but, instead of letting all the sound come out of your nose, release your jaw a little, keep your tongue flat in your mouth and focus the sound vibrations towards the front of your mouth onto your lips. Your soft palate will be part open, allowing ‘sounded air’ to flow through both mouth and nose. As your lips are closed, the sound cannot escape at the front of your mouth, so it should produce a ‘tickle’ as the sound sets the thin surfaces of the lips into vibration. If you go back to the high tongue (and soft palate setting) for head resonance, and hum a long mmm, you will no longer feel the lip tickle. Nor will you feel it if you constrict the back of your mouth and pharynx. Move between the nasal mmm and the partly oral mmm. Whether or not a client feels the lip tickle can be a clue as to whether he is backing the sound, or holding too much throat tension. As this changes, the speaker begins to feel those lip sensations.

Resonance 12: To access and practise producing forward resonance: vowels into speech Hum a long mmm and, when you feel the tickling sensation, open up into intoning the long vowels: mmmooo mmmaaa mmmeee. See if you can feel a sense of the air pulsating between your lips as the sound opens onto the vowel. Now intone the vowels oo, aw, er, ah, ee several times, still focusing on that feeling of the air and sound at the front of your mouth. As you do them, pinch your nostrils for a moment. There should be no change whatsoever to the sound quality; if there is, it is likely that you are letting sound out of your nose at the same time, with a dropped soft palate. Now intone (on one pitch) the numbers 1 2 3 4 5 6 7 8 9 10, then the days of the week and months of the year. Then speak them in an ordinary voice, but still with that feeling of forward placing.

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Speak these sentences with slightly more rounded lips than usual and a sense of excessively forward oral resonance: It would be simply wonderful if you could all join us for tea at the palace. I simply cannot conceive of what you mean shrieked tiny Miss Smidgeon. I wonder what on earth you might mean, you arrogant bumptious man.

(Make up some more of your own, containing lots of ‘front’ vowels and consonants.)

Resonance 13: To access and practise producing forward resonance: tapping the airflow Protrude your lips, like a pig snout rather than a whistle. Make a sustained ooh and, as you do so, tap the lips lightly with the three middle fingers of one hand to break up the sounded airflow. Then stop tapping but continue to feel that the sound is flowing strongly between your lips.

Resonance 14: To access and practise producing forward resonance: the friction eee sound Although this kind of exercise has long been part of the voice teacher’s repertoire, Arthur Lessac’s ‘Y-buzz’ offers a clear and carefully formulated version. It has been found to be an effective forward resonance training, as described in Barichelo and Behlau (2005). Place the front of your tongue as close as possible to the ridge just behind your top teeth. Intone a long and loud eee, but with some loud whispery friction happening as the air streams out of the narrow gap between the front of your tongue and the alveolar ridge. Keep repeating this. Very slightly drop your tongue so that the friction ceases but the loud eee continues, and focus all of its sound energy into that very small front-of-mouth gap. You may feel the vibrations in that small space, or elsewhere at the front of your mouth or face. Then alternate between eee and ooo, keeping a strong lip tension in the movements and your lips fairly tight as you do so; you may hear some overtones as you shape the sounds. Hold your nose for a minute to check that there is no change to the sound – there should not be so long as the sound vibrations are focused out of your mouth, not your nose.

Resonance 15: To access and practise producing forward resonance: nasal–oral contrast on eee–ooo Now add in nasal tone, keeping the energetic lip tone and shaping the same vowels. In the nasal version, most of the vibrations will move into your nasopharynx and out of your nostrils, but the firm lip shaping will help you to get that front sensation. Move into

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producing a fully oral eee–ooo, and then alternate between the nasal and the mouth versions.

Resonance 16: To feel and hear the contrast between head and oral resonance qualities: nasal and vowel Make a long hummed mmm imagining it buzzing in your head, and move it into an open oral resonant aaa. Then move between nasal and oral resonance in mmaaa nnaaa ngaaa (i.e. do not let the vowel be at all nasalised). Then deliberately let the vowel be nasalised. Finally alternate between a forward placed aaa with oral resonance and a nasal aaa.

Resonance 17: To feel and hear the contrast between head and oral resonance qualities: fingers waving in the air stream Place the fingers of one hand just in front of your mouth, pointing upwards with the palm facing your larynx. Make a long forward placed oral aah and, as it emerges from your mouth, wave your flat fingers quickly from side to side across the stream of air, or towards and away from your mouth. You will feel and hear a rhythmic interruption to the sound. Then direct the aah through your nose, so that it has a distinctly nasal sound. Do the same movements with your fingers in front of your mouth, and you will hear significantly less interruption.

Resonance 18: To feel and hear the contrast between head and nasal resonance quality: fingers in ears Make a long intoned aah sound. Put your fingers into our ears and alternate between a fully oral sound (palate up) and a fully nasal sound (palate down). You will hear the latter more clearly as it seems to ‘ring inside your head’.

Resonance 19: To feel and hear chest resonance quality: chest beating Rub your hands on the diaphragm area and stomach muscles; then rub across your upper chest. Gently beat the upper chest and then the lower ribs and middle of the body with your clenched fists, as you intone aah with a freely dropped jaw. Allow the vibrations to be affected by the pummelling. Try some other long vowels. (If working in pairs, have one person gently beat the other’s back as they intone.)

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Resonance 20: To feel and hear chest resonance quality: hand resting on chest Place one hand flat and spread on your upper chest, and intone some long vowels with a slightly breathy phonation, seeing if you can feel the vibrations under your hand. Then deliberately tighten the pharyngeal/laryngeal area and hear and feel what effect it has on the sound aah (it reduces the sensation of chest resonance). Intone the numbers 1 to 10, the days of the week or the months of the year, with increased chest resonance. Then speak them in an ordinary voice, but still with a feeling of slightly increased chestresonant quality.

Resonance 21: To feel and hear chest resonance quality: the quiet huh (This is inspired by Kristen Linklater (2006), who writes that the sound ‘huh’ should be ‘the primal, unformed, neutral one that happens when there is no tension in the throat or mouth to distort it and no vowel demand to mould it’.) Lying down in the semi-supine position after basic body and breath work, towards the end of a relaxed out-breath let a very quiet huh huh escape through your lips. Put your hands on the place that you feel movements of breath ‘behind’ the sound. Repeat several times, moving your hands lower on your body, and picturing the sound originating and resonating more deeply within your body.

Resonance 22: To feel and hear chest resonance quality: speech Release your jaw, and speak a few vowels with open throat, lowered larynx, lax vocal folds with breathy phonation quality and low pitch. You should hear that ‘deeper’ chest resonance quality: a sound that might match emotion words such as ‘warm, seductive, fruity or echoing’. Speak these sentences in that quality: Aah, my darling Charles, you can’t break my heart like this! Charles’ dark heart was far harder than Mark’s. You just can’t demand that I carve up part of a shark.

(Make up more of your own, containing lots of open vowels.)

Resonance 23: Playing the resonance: humming into the body (Also good to do in pairs, with a partner’s hands on the back of the other’s body.) Lying down in the semi-supine position after basic body and breath work, place your hands on different parts of your body, and hum on long vowels trying to imagine that the focus of the sound is under your hands.

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Resonance 24: Playing the resonance: sentences We can make up sentences with consonants, vowels, vocabulary and feeling that can predispose us to use a particular resonance quality. This task asks you to speak all of them in each of the resonances in turn – head, nasal, chest – so that you have to over-ride any conditioning that influences resonant quality: I’m a gnome, I’m a gnome, I’m a gnome! My mother must make more marmalade on Mondays. Minced meat never seems to minimise my migraines He’s a mean little man who needs to mind his manners. I’m sweet, sweet, sweet, sweet, sweet! It would be simply wonderful if you could all join us for tea at the palace. I simply cannot conceive of what you mean, shrieked tiny Miss Smidgeon. I wonder what you might mean, you arrogant bumptious man, you. I’m huge, huge, huge, huge, huge! Aah, my darling, you can’t break my heart like this! Charles’ dark heart was far harder than Mark’s. Would you like to come up and see me sometime?

Resonance 25: Balancing the resonance: the figure of eight A classic voice teaching exercise, this helps to encourage balanced vocal fold vibration and bring the resonance forward. Actors and singers should be able to repeat this twice on one breath. It can be intoned several times, each at a different pitch, or each sound can be sung at different points up and down a scale. Let the breath drop in deep, and then, following the direction of the arrows in Figure 22.1, start intoning on a strong and open mmah, and move around the figure of eight.

Resonance 26: Balancing the resonance: the resonating ladder (Few voice exercises are easy to fully describe in writing, but this is one of the hardest!) Stand with feet parallel, firmly connected to the ground, and knees not locked. The body needs to be rooted in the neutral position described in Chapter 18. Take time to sense the

mmor

mmay

mmah

mmoo

mmor Figure 22.1 Figure-of-eight exercise.

mmee

mmay

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breath move deeply in and out of your body. When you feel that you have good strong breath support, start intoning a rather tight nasal nng sound on a comfortable mid-pitch. Have the sense that you are placing that nng right up in the front of the top of your head. Enjoy the feeling, then gradually begin to move the sound ‘down through your body’. To do this you will slowly and smoothly open up the vocal tract, allowing the soft palate to drop away from the pharyngeal wall, the tongue to flatten, the jaw to open increasingly wide, the pharynx to stretch wider, the larynx to drop and your whole channel to gradually open and fill with the sound. First time round, I suggest placing your hand on the top of your head as you start the nng, and then, keeping your fingertips in touch with the front of your body, move them down as the sound deepens in resonance. The fingers should touch where you have the impression that the sound is most felt in the body. (Some people end up with hands on groin, knees or even feet.) As the sound moves down you will naturally modify its shape so that it will move from nng through an ee, into an aa and then down into a deep err when it ‘reaches ‘ your lower chest. (You will stay on one breath and one pitch throughout the exercise, but because of the increasingly deeper resonance, a listener may think that you are getting deeper.) When doing this in a group, I encourage the bodies to adapt to the sound, so that people may end up with legs wide apart, arms spread out and faces and mouths widely stretched. At this point, it’s the sound that matters – not how you look!

Resonance 27: Balancing the resonance: Fee Fie Foe Fum Speak the giant’s threat with an awareness of full resonance – a big open vocal sound with no throat push: Fee Fie Foe Fum I smell the blood of an Englishman Be he alive or be he dead, I’ll grind his bones to make my bread!

Resonance 28: Balancing the resonance: the Fatima factor I use this text to encourage presenters to take risks with dramatically increasing pitch and resonance variety. Here it is used with the aim of mixing all three resonant qualities in a big full sound – encouraging people to come in to see the beautifully fat lady: Ladies and gentlemen, in the tent behind me is Fatima. She’s the fattest lady in the world! Wonderfully, gloriously, exotically FAT! She weighs five hundred and fifty pounds! It takes a tractor to tug her and nine men to lug her! Get your tickets now! Don’t miss this chance!

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Resonance 29: Balancing the resonance: speaking thoughts and texts Having worked to open up the resonant qualities, suggest that the speaker reads aloud, speaks any text on which she may be working, or simply voices her own thoughts. As she does so, she deliberately varies between excessive versions of head, oral and chest resonance qualities. After a few minutes she moves into a voice with a balance of all three qualities.

Resonance 30: Further explorations of resonance: free voicing Many of the sound improvisations that are described in Chapter 26 are excellent for resonance work because they encourage people to explore new vocal qualities and resonances, where they may never have been before. The group sound supports them in the confidence to explore. Occasionally I tell a client about the activity of free voicing (described in Chapter 15). This would be suggested only to those who have already done considerable self-exploration and who are willing to play with their voice in imaginative and sometimes rather daunting ways. In this, a person starts by doing some quiet breathing to access feelings and energy, and then allows any vocal sound to begin, letting the sound move in any way that feels right, through a range of different qualities, volumes, resonances and pitches. This may simply use long vowel sounds over a period of time (toning) or involve a range of nonsense sounds and syllables with lots of consonants and vowels (sounding).

Chapter 23

Pitch voice exercises

The free voice has an appropriate centre pitch with flexible range for any emotional, semantic or vocal need. The exercises described in this chapter draw on both the spoken and singing voice traditions, because we can work on pitch in either medium. A singer recovering from a voice problem can practise pitch extension in speaking up and down her pitch range; this works on vocal fold flexibility and is less threatening than trying to hit the precise notes of a scale or arpeggio. A speaker who needs to enliven his pitch range in presentation can be encouraged to extend singing and speaking pitch in the privacy of his own car. Clients inhibited by the idea of singing may feel more comfortable with an exercise where they are required to ‘intone up and down’ or ‘speak between pitch levels’. Pitch changes ‘flex’ the vocal fold surface tissues and the underlying muscle, and carefully designed vocal fold flexibility exercises can be useful for clients recovering from certain vocal fold problems. Voice work sometimes has to help a speaker find and use a more appropriate centre pitch, but most exercises focus on extending pitch range. In this chapter the word ‘range’ is used to refer to exercises to develop both the highs and lows of pitch and the variety of intonation patterns.

Pitch 1: To find the mean pitch: acoustic analysis Only acoustic analysis can provide an accurate analysis of a speaker’s average spoken pitch and pitch range, but is usually confined to the clinical setting. Here it can form an important tool for work with transgender clients, because the average spoken pitch can be compared with the pitch norms for the target gender voice. Being able to ‘see’ pitches in acoustic analysis (and other aspects of voice) can be of value in teaching singing (Howard et al 2007), but few singing studios as yet have access to such tools. Interested singing and voice teachers sometimes set up collaborations with local specialist voice centres or the phonetics departments of local universities.

Voice Work: Art and Science in Changing Voices. Christina Shewell © 2009 Christina Shewell. ISBN: 978-0-470-01992-4

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Pitch 2: To find a comfortable centre pitch: piano or keyboard Guidance for ‘comfortable pitches’: the A below middle C is in the area of the average female spoken pitch, and B2 (an octave and a bit below middle C) is in the male centre pitch area. Find a pitch on the piano where it feels comfortable for your voice to intone the note several times. Play that note several times with one finger as you hum it, and explore whether that feels and sounds too high or too low to be a comfortable spoken centre pitch. A way to do this is to hum, ‘open the hum up’ into mmmaaa and then take it into an intoned sequence of numbers 1 to 10. Then again intone the numbers 1 2 3 4 5 on that pitch, but move into speaking the numbers 6 7 8 9 10 in a conversational way, trying to stay centred around that pitch. See how it feels. Finally intone a sentence on that note. Then allow the pitch to move around but see if it feels right to keep that note as your centre pitch. If this feels and sounds too high or too low, try one note higher or lower. Repeat the sequence until it seems that you are speaking at your habitual pitch level. When working with a client, you can play the notes while the client follows through the sequence. Demonstrate first and let the speaker practise on a high and then a low note before you start the more subtle distinctions of closer-together notes.

Pitch 3: To find a comfortable centre pitch: octave up from lowest note Turner (1950) wrote that a comfortable centre speaking pitch could be found ‘by first singing down the scale until the lowest note which can be sung is reached. Sung, not growled! An octave above this will give a note towards the middle of the voice, and this, or a note slightly below, should be used in the first place for all vocalization exercises’.

Pitch 4: To find a comfortable centre pitch: bouncing and running The idea is that all these activities help to release tensions and allow an easy mid-pitch sound to ‘drop out’. Sit on the edge of a chair seat. Bounce up and down by pushing on your feet, drop your jaw a little and let an easy huh come out of your mouth at what feels like a mid-pitch. Stand up and have a stretch. Jump up and down and let an easy huh sound come out as you do so. Still standing, raise yourself up on your toes and, as you let your heels drop, again let that easy huh sound bounce out. Do this a few times, and then make an equally easy short mmm. Run, jump or walk around the room letting huh and mm sounds emerge from your halfopen mouth, as if bounced out by your movements. Stand still, and intone a steady mmm on the same pitch that you have found for the shorter sounds. Then open up the hum into a long maa.

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Pitch 5: To find a comfortable centre pitch: the comfortably agreeing sound Say a relaxed and agreeable hmm hmm. Repeat this several times, and then take the sound into intoning on a steady mmmmm. Repeat several times. Then open up the hum onto mmmaaa. Move this intoned sound smoothly into intoned 1 2 3 4 5 6 7 8 9 10, keeping the numbers at that same basic pitch. Then say a few words and sentences on that pitch, before allowing the pitch to move around as you speak, but still staying with the same centre pitch.

Pitch 6: To find a comfortable pitch around or below the centre pitch: released huh (This is based on Linklater [2006] and is a great way to access the release of an easy natural voice.) Lie down or sit with supported head, and have your hands on your lower breathing area. Linklater describes an image of this area as a ‘deep, calm forest pool with a surface roughly level with your diaphragm and its depths in your pelvic region’. Take time to imagine this and picture your breath entering and leaving this place. As a silent breath leaves, let your lips be a little open, and your throat and tongue in the relaxed shape needed to shape a silent huh sound. Then imagine that the pool is full of sound vibrations. As the breath flows out, let a quiet voice come in, with no push or strain, as if a ‘bubble of vibration breaks the surface of the pool’. Repeat a number of times, and then extend the sound into a longer huuuuh sound.

Extending pitch range and variety Extending the pitch range and variety is an important part of any voice work on vocal energy and interest. Speakers may have a deep fear of going too far, but, as we saw in the area of jaw release, many speakers overestimate any extension from their habitual patterns. Faced with a group of tired acting students who said that they were afraid of ‘going over the top’ in a challenging Restoration play rehearsal, the irritated theatre director with whom I was working told them: ‘My darlings – most of you have no idea where the top is, and there’s certainly no danger of any of you going over it.’

Pitch 7: To feel the laryngeal involvement in pitch change: silent pitching This can be used when there is vocal fold damage but you feel that gentle vocal fold stretching and thinning may be therapeutic.

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Place your fingers to gently touch the sides of your larynx. Imagine singing or calling on a high note and you will feel some movement, as the thyroid cartilage tips forward and your vocal folds stretch and lengthen. Then do the same on a low note, and feel the difference. Now take your fingers away and see if you can feel those internal adjustments.

Pitch 8: To become aware of one’s pitch range: humming conversation This is a way to demonstrate the pitch rises and falls of speech to a client with whom you want to work on pitch extension, because it alerts them to the musicality of speech. Having discussed pitch, hum the tune of the last sentence that you spoke. Speak a few more sentences, with different intonation patterns and, after each one, hum the tune in which you say them. Ask the client to hum a sentence that you speak, and then to say her own sentence and hum its melody. You can discuss any differences or restrictions.

Pitch 9: To extend the pitch range: exploration with piano or keyboard (This is an extension of the Pitch 2 exercise.) Identify a note that is a couple of tones above or below the place that you have identified as your centre pitch. Play that note several times with one finger as you hum it, and then ‘open the hum up’ into mmmaaa and then take it into an intoned sequence of numbers 1 to 10. Then again intone the numbers 1 2 3 4 5 on that pitch, but move into speaking the numbers 6 7 8 9 10 in a conversational way, trying to stay centred around that pitch. Intone a sentence on that note, and move into chatty speech, keeping that same centre pitch. (You will either be speaking above or below your usual pitch level – it is supposed to sound and feel quite strange!) Then deliberately move up and down the keyboard, exploring different centre pitches. Go as high and low as you can comfortably reach, and do not worry if it sounds ridiculous!

Pitch 10: To extend the pitch range: climbing stairs Speak up and down your pitch range on a vowel or a word. Start as low as possible and go to the highest that you can manage; I generally use seven steps, but you can use more or fewer. up up down up down up down up down up down up down

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In groups, it can be amusing to ‘climb the stairs’ with short phrases because their emotional meaning seems to change with the pitch, e.g. try ‘don’t do that’ or ‘I love you’ or ‘I’ve never seen anything like it!’.

Pitch 11: To extend the pitch range: the ‘wait’ sequence Speak these words – going up or down your pitch range, so the ‘Now!’ is at the very top or the very bottom of your pitch. The aim is to rise in pitch, not loudness: wait wait wait wait wait wait wait wait – NOW!

Pitch 12: To extend the pitch range: drop downs and rises with varying pitch change Stretch up, arms above head and drop quickly down as you glide down on a long falling pitch aah. Bounce there for a minute and then uncurl as you make a long glide up on aah with rising pitch. Change the vowel to eeh or ooh. Then reverse this; let the sound rise in pitch as you drop down, and then slide down in pitch as you stretch up. The reverse is generally quite difficult at first. It’s an important exercise, because amateur singers and/or actors frequently raise their heads, eyebrows, eyes and other parts of the body as they rise in pitch, which is not visually elegant!

Pitch 13: To extend the pitch range: glides and sirens • Do some glides up and down the pitch range on eeh and other vowels. • Glide up slowly and sustain the top note in a kind of quiet controlled shriek. Glide down and let the lowest pitch go into an easy non-strained creak. • Then do some strong sirens on ng, moving the sound smoothly up and down between a low note in your range and a high note. • The very slow glide up and down (taking 10–15 seconds to rise and 10–15 seconds to fall) is a very good exercise for pitch control, and particularly valuable for singers. McKinney (1994) writes: ‘Singers frequently support well going up a scale but relax excessively during descending passages, and have virtually no effective support in portions of their mid and lower ranges.’

Pitch 14: To extend the pitch range: ‘noises off’ There are lots of vocal noises that require extensive pitch movements, and children generally enjoy making them. The idea of ‘noises off’ is that the client or group is given the task of

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providing the sound effects from the theatre wings of an amateur play. (They will need to accept the unlikely nature of this task.) Here are just a few: Whimpering dog and lovesick gorilla. Ambulance or police car rushing through streets. Village ghost. Rushing water in a stream. The wind; first of all with breath alone on the sound fff, and then with a kind of ghost singing on the sound whoo. Let the wind change in its strength, from rustling the leaves to blowing off roof tiles. Howling wolf. Cackling hyena.

Pitch 15: To extend the pitch range: counting up and counting down the range Count from 1 to 20 starting at the bottom of your pitch range and rising to the top. Then count from 1 to 20 starting at the top of your pitch range and rising to the bottom. Then count 1 to 20 alternating numbers very high and very low. In a group class the practitioner or group member can ‘conduct’ this by using his hands to show the height at which he wants the pitches to be. Instead of counting, the group can recite a simple nursery rhyme or poem that they all know, or read a text from a flip chart or other visual aid.

Pitch 16: To extend the pitch range: sentences Start as low as you can go in your pitch range, and move note by note upwards, intoning an easy open eeh or other vowel. Then come down. Use short sentences to move up note by note in the same way. See if you can move up through each note from the bottom to the top of two octaves. Then move randomly between high and low notes.

Pitch 17: To extend the pitch range: ‘yes’ and ‘no’ improvisations The task is to speak ‘yes’ 10 times, in as many different pitches and qualities as possible, and then to do the same with ‘no’. It can also be done as an improvisation where they are spoken alternately, as if having an argument with yourself, or in pairs, with one speaker saying ‘yes’ and the other ‘no’.

Pitch 18: To extend the pitch range: the Swannee whistle mm ‘Read’ aloud some phrases, only using the sound mm and trying to convey the meaning by varying the pitch of the mm sounds.

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Pitch 19: To extend the pitch range: quickly rising ha Say ha ha ha ha on a strong panting abdominal movement – going up the pitch range, higher and faster and then back down.

Pitch 20: To extend the pitch range: step-by-step notes The traditional scale or shorter sequence of notes is useful in vocal remediation because the vocal folds are gradually changing length, tension and speed of vibration. Singers will usually be quite comfortable about singing up and down in this way. Non-singers can intone such ‘graded’ notes on hey, on short or long single vowels, or use vowel combinations (e.g. oo–ee). Speaking up a scale in staccato is a useful exercise that bridges speaking and singing skills, because it demands considerable breath–vocal fold coordination skill.

Pitch 21: To extend the pitch range: jumping notes If the gradual changes of this last exercise are easy and comfortable, a client can be asked to move between pitches as you play them on a piano, or to imitate words said at a variety of different pitches.

Pitch 22: To change repetitive falling or rising intonation patterns: listening, imitating and doing the opposite Record the client speaking for at least 5 minutes and play this back to him. Identify the pattern that you want to change, and have the client listen for sentences in the recording that have the ‘problem’ intonation. Ask him to repeat every such sentence, and then immediately say it again with the opposite intonation (i.e. if it falls too much, to lift the pitch towards the end of the sentence – and vice versa). There will need to be a number of repetitions as you are working to change both auditory recognition and pitch use. Body movements and gestures can be used as the client learns ‘new tunes’, e.g. raising arms as the pitch rises, or sinking down as the pitch falls.

Pitch 23: To maintain the same pitch with increasing loudness: controlled crescendo Intone a long vowel sound note on one steady pitch, and let it get louder without going up in pitch. Then stay on one intoned pitch and let the volume alternate between loud and soft. Try it on different pitches. This deceptively simple exercise helps the control of breath pressure and vocal fold coordination. If we ask an untrained speaker or singer to produce a crescendo on a long aah

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the voice will rise in pitch as it gets louder. Singers need to be able to get louder without going up in pitch, and training always attends to this important skill.

Pitch 24: Playing with pitch: nonsense syllables Sundberg (1987) found that nonsense speech contains no heavy syllables and consequently the subglottal pressure curve is much smoother. Speak repeated consonant vowel syllables (e.g. bah bah bah; dee dee dee; leh leh leh, etc.) with varied intonation, as if communicating in a chatty manner.

Pitch 25: Playing with pitch: gibberish Gibberish is an extension of nonsense syllables in that it should have a wider range of sounds and ‘pretend’ words, and should sound like a made-up foreign language. Some people hate doing it, some love it and others just find it extremely difficult. It enables a wide range of pitches to be used, and provides extension in other aspects of voice. It is certainly more fun to do in a group, but one client reported using gibberish to express the quality of her working day as she drove home alone!

Pitch 26: Playing with pitch: intoning and chant talk Phonation exercise 28 illustrated different meanings for the words ‘intone’ and ‘chant’. When we intone sounds or word, they are prolonged and stay at one pitch, so the vocal fold length and tension do not change significantly. In chanting, sounds and words are also prolonged but they vary in pitch, within a fairly narrow range; the vocal fold length and tension change, but there are much slower transitions than in speaking. This allows more time for deliberate vocal fold adjustments. In an interesting study, McCabe and Titze (2002) found that chant therapy (practice with a chant pattern from the Gregorian tradition) benefited teachers with vocal fatigue. Intone the numbers 1 to 10, the days of the week and the months. Then read a passage intoning all the words on one pitch. Then speak about something with the same intoning style. Now chant the numbers 1 to 10, the days of the week and the months. Use this chanting to read aloud, and then to speak.

Pitch 27: Playing with pitch: particular words Collect a range of words with different emotional qualities in their meanings which can be reflected in the pitch in which they are spoken. For example: rise, high, low, tremble, shriek, moan, tiny, enormous, cheery, depressed, Monday, dance, slump, fall, fly etc

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Clients can explore these and then speak each in the opposite pitch. Martin and Darnley (1992) offer a range of words and sentences specifically chosen for pitch practice.

Pitch 28: Playing with pitch: a sequence of dramatic sentences Start low and let the pitch rise slightly on each new line: It’s very dark in here I don’t like the look of it all Let’s go in and see what’s going on You go first and I’ll follow [this one should be around your centre pitch] Come over here! Look what I’ve found! Isn’t it extraordinary!

Pitch 29: Playing with pitch: radio newsreader Read an article from a tabloid newspaper (shorter sentences than a broadsheet) in the style of a radio newsreader, with extended pitch movements up and down. Try to start a new sentence on a different pitch to that which ended the previous sentence.

Pitch 30: Playing with pitch: prose in manic pitch Read a piece of prose aloud, alternating the sentences between high and low pitches. After a few minutes, read it with a wildly exaggerated range of intonation, as if you were quite hysterical with excitement. Then come back to ordinary reading but keep a slightly increased rise and fall of your pitch options.

Pitch 31: Playing with pitch: dramatic play texts Select a suitable play and choose a short section that has two characters, whose voices would be at different pitches. A client can either read this with you or read both parts. (Make sure that it is a modern play, as you want the language to be colloquial not classical.)

Pitch 32: Playing with pitch: poetry As with singing, some clients are inhibited by the idea of reading poetry aloud, but, if carefully selected for a particular client, a poem can provide an experience where voice in words, phrasing and pitches is used in a quite different way from the speaker’s habitual patterns.

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Pitch 33: Playing with pitch: singing So long as it is not in any way strained, most singing is a good way to explore pitch. Many people who would never sing in public may be willing to sing in the car or alone at home, but if this is not a usual habit, they may need encouragement. Even solitary self-consciousness can cramp a throat and limit pitch range. I sometimes use a nursery rhyme or the simple drinking song below as a ‘way in’ to singing, for those who tell me that they have always longed to sing but can’t. First of all I sing it, then we sing it together a few times – and then – if he feels up to it – the client sings it alone. The motivation to continue is crucial so at this point any sound whatever is highly praised – for courage if for nothing else! Simple drinking song Show me the way to go home, I’m tired and I want to go to bed, Well I had a little drink about an hour ago And it’s gone right to my head. Wherever I may roam, On land or sea or foam, You will always hear me singing this song, Show me the way to go home.

We talk about how this might be continued, perhaps just singing lah to accompany popular songs on radio or CD, singing songs remembered from childhood or joining any of the group workshops often run in cities, with the titles such as ‘Singing for the Terrified’. I stress that the aim is not the development of a great singing voice; it is the muscular doing that matters – opening up the mouth to make any sort of musical sound with all its range of pitch and resonance. Over the years a number of my own clients, self-avowed ‘nonsingers’, have moved into some sort group or choir singing once they have ‘found their own voice’. Many practitioners will share the experience that voice work can set a client off on a journey of vocal and personal discovery.

Pitch 34: Playing with pitch: gesture to ‘warm up’ pitch movements Some speakers use a lot of gesture as they talk; in public speaking this may be distracting and suggest an over-nervous energy. This is an exercise designed to deliberately use changes in face, hand and body when speaking, but then to transfer that movement energy into pitch, speed and loudness variety. Tell this story twice: 1. First – speak each thought or sentence with an appropriate exaggerated facial expression, gesture or movement. 2. Second, use no gesture but allow the energy and movement to be in your voice.

366 Voice Work: Art and Science in Changing Voices The Box Factory (A text from the late Tom Pinder, at the Simpletons Speaking Club in the City of London.) Last week I went on a long journey by train. I visited a cardboard box factory. They make small boxes, medium size boxes and huge boxes. These are sold all over the world. It was very cold when I got there. Icicles hung on the iron gate and my finger stuck to the bell. A very old bent man opened it. He pointed to a side entrance, and behind the door I found a spiral staircase. I walked up and up, round and round. At the top I entered a vast echoing room, which was full of women folding cardboard into intricate shapes. I was given samples of each size of box – from tiny to enormous. I held the pile close to me and started down the stairs. But I couldn’t see my feet, and I slipped on a patch of ice. I fell all the way down – bump, bump, bump. A horrible shock. Five days later, I’ve still got a large lump on my head – and no boxes.

Chapter 24

Loudness voice exercises

The free voice has a flexibility of loudness for emphasis, variety and different situations, with an appropriate power support.

Loudness 1: To tune into one’s own loudness level: the Loudometer The habitual spoken voices of some people may be too loud for the comfort of their vocal folds or the ears of their listeners. Other voices are too quiet to be easily audible, or do not express the image that a speaker wants. Even though acoustic analysis software can show the exact loudness level of a voice, all clients have to be able to self-monitor by using their own hearing. The Loudometer is an imaginary scale of loudness, an idea inspired by Boone’s (1982) five-point loudness scale. Ask the speaker to imagine a speedometer or dial or temperature gauge – whichever works best for that person. On this are seven numbers: 1 2 3 4 5 6 7

= = = = = = =

mouthing (no whisper or voice) whispering (with no throat tension) quiet voice normal conversation heightened voice (as if speaking to a large group) loud voice (calling someone who is another room) yelling.

You can explore those different levels together and discuss at what level the client would place herself in ordinary life. Some energetic young women with vocal nodules talk continuously at level 5; this simple image of a loudness gauge helps them to recognise this and to move to a quieter level. We can also use a recording device so that a speaker can hear herself talking at different loudness levels. In work with younger speakers, friends or family may become involved

Voice Work: Art and Science in Changing Voices. Christina Shewell © 2009 Christina Shewell. ISBN: 978-0-470-01992-4

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with an occasional reminder to ‘change the gauge’. The aim is always that the speaker begins to ‘catch herself out’ at times when her loudness level rises too high. If there is a need to raise the habitual volume level, a shy client can ‘play’ with different levels to experience options, and perhaps then be less afraid of ‘coming out’ with his voice. Accessing an increased loudness may be an important part of both vocal and emotional strengthening.

Loudness 2: To connect to the low power source (abdominal breath support): steady voiceless sound I often start loud energy work in the semi-supine position because it allows people to focus on the lower breath, and stops them pushing forward with head and neck as they get louder. But these exercises can equally well be done sitting or standing. Take time to connect to an awareness of lower breath. Blow a strong stream of air up to the ceiling on a steady fff. Concentrate on deliberately making the abdominal muscles, ribs and lower back move as the fff streams out, and feel that air between your lips. Keep your eyes open and direct the sound to a point on the ceiling; check that there is no jaw or facial tension inappropriately trying to push the sound out. Repeat several times. Do the same on sss or shh. Then make long crescendos on these sounds – holding that awareness that the power behind the loudness is low in your body. See how strong you can make the sound. If at any point you tense throat or body, shake your arms and then your legs, stretch, yawn, chew, sigh – and start again.

Loudness 3: To connect to the low power source: short voiced sounds Stand in neutral and make some short loud vv vv vv sounds, ensuring that you feel short strong abdominal movements as you make each one. Feel also a strong forward vibration on your lips. Then make a loud zzz and // (the sound in the middle of ‘measure’), and mmm and mmaa.

Loudness 4: To develop breath and loudness coordination: voiceless crescendo–diminuendo (This exercise is also described in Chapter 19; it is included here because it is so relevant for safe loudness skills.) Make 5–10 crescendos (start quiet and get gradually louder) on long fff, sss or shh sounds – one breath for each go. Direct the sound to a point on the ceiling or wall. Check that you are supporting the sound from low in your body, and not extending your head forwards, or pushing with extra jaw, lip or facial tension.

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Now do 5–10 crescendo–diminuendo patterns on fff moving from quiet sound to loud, and then back down to quiet again. See if you can do 3 seconds quiet, 3 seconds loud and still have the breath control for a final quiet 3 seconds. If that timing is easy, build it up – to 5 + 5 + 5, 6 + 6 + 6 and finally 7 + 7 + 7.

Loudness 5: To develop breath and loudness coordination: voiced crescendo–diminuendo Repeat the above exercise but this time do it with the prolonged voiced sounds of vvv, zzz and zzh (//). If you notice that laryngeal tension is gripping the throat as you become louder, start on a voiceless sound and move smoothly into its voiceless partner, e.g. fffvvvvVVVVvvv. Then open the sound up onto a vowel – zzaa, zzhee, zzzoo, vvvey and so on. Move onto mmaa, nnaa and ngaa. Make sure that the consonant and vowel last the same length of time and the move from one into the other is as smooth as possible. Try to avoid going up in pitch as you get louder.

Loudness 6: To develop breath and loudness coordination: ‘messa di voce’ (This is a classic singing exercise for dynamic control.) Intone a mid pitch long note on a vowel – eee, ooo, aaa. Start very quietly, let the sound build up in loudness, and then, while you still have plenty of breath left, seamlessly decrease the loudness until you are back at the original quiet level: ee ee ee ee ee ee ee ee ee ee soft LOUD soft

Control improves as the client monitors how to control the sound in terms of both kinaesthetic and auditory feedback. She is learning how to coordinate subglottic air pressure with vocal fold closure and tension; this is a crucial skill for vocal performers but is also relevant in vocal remediation.

Loudness 7: To work on loudness without strain: intoned sounds with arm extension Place your folded hands flat over the centre of your chest. Start a quiet long haah sound; let this sound build in energy as you slowly move your hands and arms away from your body, first of all to the front and then stretched right out to your sides in a T shape (Figure 24.1). By the end of the movement sequence, your sound should be as full and loud as you can make it. Use any other long vowels or voiced fricative consonants in the same way.

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Figure 24.1 Intoned sounds with arm extension.

Loudness 8: To work on loudness without strain: finger and hand movements Stand in neutral, bend your elbows and curve your hands in towards your breastbone. Flutter your fingers in front of the chest using very small movements as you begin a very quiet haah; gradually increase the loudness of the sound and, as it grows, let your hands move in bigger and bigger movements until the entire length of your arms is shaking as a big sound emerges. Let the body move too if it wants.

Loudness 9: To work on loudness without strain: belly laughs and strong heys Stand with firm parallel legs, with awareness of lower breath support and open channel, and make a small huh sound. Yawn down your pitch range, several times. Rub your stomach, round and round. Make an easy ‘belly laugh’ – first softly, then at mid-loud level and finally quite loudly. Keep the jaw released. Call a quiet hey. Gradually build up the loudness of that sound, until you are calling loudly on a prolonged heeey! Shake your limbs and body, drop over from the waist, uncurl slowly up again, drop your jaw and yawn twice down your pitch range (all designed to release any tendency to throat

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constriction). Then do some more long strong heeey sounds, increasing the volume until you are calling the sound as loudly as is comfortable. Now use an image. Picture a friend across the other side of a busy road, and call heeey to him. Watch as he gets further from you – call louder – then he goes further away still – so your sound needs to be louder still. Keep that sense of the wide-open jaw and throat, with no constriction in either, and lots of abdominal breath movement.

Loudness 10: To work on loudness without strain: the energy chant Stand with your arms by your side. Chant ‘ENERGY! ENERGY! ENERGY! ENERGY! ENERGY!’. Make each word louder than the last. At the same time, in synchrony with the words, raise your arms higher and higher at right angles to your body until they are stretching out as wide as possible as you reach full volume. Imagine the sound streaming out of your fingertips. (It does not matter if the pitch rises in this chant.)

Loudness 11: To work on loudness without strain: bah and other plosives Feel a strong abdominal pulse inwards as you say, furiously and loudly, ‘bah!’. Use that same vocal energy in other combinations of plosive-plus-vowel (pay, tah, doh, keh, go, etc.). Then use some monosyllabic words that start with these sounds – book, pad, car.

Loudness 12: To work on loudness without strain: 3 loudness levels in names Choose two or three people’s names, and call each three times, with increasing loudness: Carla! Carla! Carla! Try to keep the pitch at the same level throughout, not rising as you get louder. Some clients have practised ‘safe loudness’ as they walk their dogs. One invented an imaginary dog and would call ‘Toby! Toby! Toby!’ in a loud and imperious voice as he walked in the park. (He occasionally muttered ‘Where on earth is that wretched dog?’ as he passed other walkers.)

Loudness 13: To work on loudness without strain: ‘yes’ and ‘no’ (More fun to do in pairs.) Say the words ‘yes’ and ‘no’, at different emotional intensities, pitches and loudness levels, imagining that you are arguing with someone, at times using subtle persuasion skills and at others arguing angrily.

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Loudness 14: To work on loudness without strain: talking against background noise Ask the client to talk about something and provide a loud background noise, against which he has to make himself heard without strain. You can clap your hands, repeatedly say the word ‘rhubarb’ at a range of levels, or talk about something else in a loud and irritating voice. For clients who regularly have to speak against high levels of noise, I sometimes play a recording made in a noisy restaurant. This provides a ‘bridge’ between a quiet clinic or studio room, and the noise of the outside world.

Loudness 15: To work on loudness without strain: calling instructions against background noise Group practice gives speakers an opportunity to observe whether habitual patterns of constriction come in at high volumes when ‘really’ communicating with another person. In a group, lines of partners can practise calling instructions to each other across a room: Raise your hands! Touch your head! Jump on one leg!

Loudness 16: To work on loudness without strain: special training when needed Actors and musical theatre singers may have to produce high emotional and loudness intensity eight times a week. It is essential that they learn how to do this safely, because screaming and shouting place heavy demands on vocal folds. Some voice teachers have special experience in this area, and offer valuable workshops for actors and other voice practitioners. My own work has used non-verbal sounds as a basis for this work, exploring gradually increasing loudness levels in the ‘natural sounds’ (described at the end of Chapter 20), and developing these into loud moans, whoops, howls, sirens, hoots, shrieks, screams and bellows.

Loudness 17: To work on emphasis: pitch and loudness together In this classic exercise, the speaker is required to change the stressed word in sentences, so the meaning is shifted. For example: It was John who said he could walk there in half an hour. 1 2 3 4 5 6 7 8 9

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Loudness 18: To work on emphasis: loudness alone As described in Chapter 13, emphasis is often created by several voice features, but variation in loudness plays an important part. To tune a client into its role in emphasis, ask him to intone a practice sentence on one note; this time he must show which word is stressed by loudness alone. It was John who said he could walk there in half an hour. 1 2 3 4 5 6 7 8 9

Loudness 19: To develop loudness variation in presentation: loudness cards Emphasis tells listeners to notice a particular word or point, but skilled public speakers also use their voices at soft and loud volumes in a more general way, to shape the rhythm and subtly affect the emotional feeling conveyed. Some speakers write reminders on their scripts to ‘speak up’ at certain points in a speech. I do not generally suggest this because it can stifle spontaneity. Instead practical work offers opportunities for a speaker to try out different loudness levels, because these are then more available in real life. As the speaker does a practice presentation, the practitioner holds up cards with different loudness level numbers, or descriptive words. Options might include ‘soft and persuasive’, ‘intense’, ‘histrionic’, strong and assertive’, etc. For a few minutes the speaker is required to adjust her loudness level according to the cards. This is clearly an artificial and mechanical exercise, but the practitioner then puts the cards away; the speaker continues speaking, exploring how loudness variety might appropriately relate to the points that she is making.

Loudness 20: To explore loudness variation: a Peking opera exercise Imagine that you are shooing chickens, trying to get them back into their house for the night. First of all, encourage one chicken by doing an appropriate movement and making a high, thin, fold ‘shoo’ sound several times. Then imagine that you are herding 10 chickens, again with suitable movements and a high long ‘shoo’ sound. Finally, try to move 100 chickens into that house; find the movement and the quality of ‘shoo’ that would be needed for this louder sound.

Loudness 21: To explore loudness variation: using dramatic texts Made-up speeches – tailor-made for the client group What I have to tell you is very important. If we do not make the changes outlined in this report, it is not just productivity that will suffer. Respect for our work, the security of our jobs, the

374 Voice Work: Art and Science in Changing Voices welfare of our dependants – all will be placed in jeopardy. The time has passed when we could sit back and congratulate ourselves on having a well-run ship. We have heard this evening of the catalogue of disasters that have occurred since the beginning of the year. Now we have the power to say – yes, things have gone wrong but we can change this. We are fighting for our lives, but we have a new awareness, a vibrant energy and a crystal clear determination – we shall win!

Real speeches One example: Lord Byron. Imagine speaking these lines to one person, then to 10 and finally to 100 people. You call these men a mob. Are we aware of our obligation to the mob? It is the mob that ploughs your fields, that mans your ships, that has enabled you to defy all the world.

Great dramatic text Collect texts from classical or modern plays that demand the use of a strong but varied volume level. One example: this wonderful speech from Henry V offers the chance to explore building vocal energy with emotional subtlety; it has elicited passionate energised voices in a number of business-based workshops. Once more unto the breach, dear friends, once more; Or close the wall up with our English dead. In peace there’s nothing so becomes a man As modest stillness and humility: But when the blast of war blows in our ears, Then imitate the action of the tiger; Stiffen the sinews, summon up the blood, Disguise fair nature with hard-favour’d rage; Then lend the eye a terrible aspect; Let pry through the portage of the head Like the brass cannon; let the brow o’erwhelm it As fearfully as doth a galled rock O’erhang and jutty his confounded base, Swill’d with the wild and wasteful ocean. Now set the teeth and stretch the nostril wide, Hold hard the breath and bend up every spirit To his full height. On, on, you noblest English. Whose blood is fet from fathers of war-proof! Fathers that, like so many Alexanders, Have in these parts from morn till even fought And sheathed their swords for lack of argument: Dishonour not your mothers; now attest That those whom you call’d fathers did beget you. Be copy now to men of grosser blood,

Loudness Voice Exercises 375 And teach them how to war. And you, good yeoman, Whose limbs were made in England, show us here The mettle of your pasture; let us swear That you are worth your breeding; which I doubt not; For there is none of you so mean and base, That hath not noble lustre in your eyes. I see you stand like greyhounds in the slips, Straining upon the start. The game’s afoot: Follow your spirit, and upon this charge Cry ‘God for Harry, England, and Saint George!’ Henry V, Shakespeare, Scene I. France. Before Harfleur

Loudness 22: To explore loudness focus: directing the sound energy Call a long hey, with pleasure and excitement in your tone, directing the call to different points in the room. Change the emotion to one of warning. Then stand still and intone a steady open long aah, sending it to different places. Explore other vowels or mm. Picture the sound streaming out like a benevolent beam of light, shining on different places. In a group, people can stand in different places in a large room, and intone long vowels to people at varying distances. Or they can repeatedly walk across the room, directing long vowels to different points in the room, becoming louder – or softer – as they approach the point.

Loudness 23: A simple sequence for voice projection Chapter 13 described the nature of the well-projected or well-focused voice; below you see a simple work-through that could be done with a speaker whose voice has to carry. These exercises will help to ensure that listeners will hear the voice as ‘loud enough’: 1. Body: posture, stretches, shakes, swaying are all relevant movement words. 2. Breath: work to place and work the breath in the three key areas of the abdominal muscles, ribs and back. 3. Channel: ensure no excess muscular tension or constriction in the larynx, pharynx, palate, jaw, tongue, lips and face. Key open channel activities include yawning, sighing, chewing, the open throat laugh, tongue stretch, lip blow and face pull. 4. Phonation: hum to get the ‘tickle’ happening on the lips, as a check that sound is placed forward. Hum on mmm, and take it into intoned counting 1 to 10; then speak the numbers 1 to 10 in ordinary spoken voice style. Hum on mmm and speak some lines of text. 5. Resonance: hum in a very nasal tone mee mee mee, and then speak with a lot of head resonance. Lick, smack and kiss your lips, and then say in a very precise way – why why why why why. Then speak a few words with excess oral resonance quality. Chest: gently beat your chest as you do a long aah. Then speak with that quality.

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Speak the Fee Fie Foe Fum rhyme with a balance of all three resonances, or alternating lines between them. Fee Fie Foe Fum, I smell the blood of an Englishman, Be he alive or be he dead, I’ll grind his bones to make my bread! 6. Pitch: do some glides, sirens and counting up and down your pitch range. Read – and then speak – in an over-exaggerated pitch range. Then lessen but keep pitch variety awareness. 7. Loudness: call some loud heys with lots of lower breath support, open throat, forward placing, relaxed lips and tongue. Send a prolonged, steady, strong aah to different places in the room. Imagine the sound as a stream of energy or light; it is a physical stream of vibrations. 8. Articulation: specific muscle exercises for each articulatory muscle group are useful toners, but work needs to be carried over into real speech. An easy practice is to read – and then speak aloud – in what feels like your most over-energised ‘overtalk’ for a few minutes. Then lessen the effort but keep a new sense of muscular clarity.

Written text Read something you like out loud. Move more than usual, from word to word, relishing the power of each word that you speak. Try playing with the words in different ways. This might include all or any of these ideas: • • • • • • •

Whisper the whole text, ‘tasting’ and feeling the shape of each word. Speak the vowels only. Speak the consonants only. Then intone it. Then sing it. Then again speak it line by line, but let the breath drop in at every punctuation mark. ‘Send’ different lines to near and far points in the room.

Finally read the whole piece aloud in a voice that feels bigger and stronger than before. Let go of conscious effort and speak the whole text, trusting that the work is now within you – and enjoy your vocal energy.

Chapter 25

Articulation voice exercises

The free voice is shaped into appropriate words by clear, energetic articulation of vowels and consonants, with appropriate pace, pause, fluency and rhythm. As we saw in Chapter 14, there are six aspects grouped under the Voice Skills heading of articulation, all of which relate to words and the way that they work together in connected speech.

Words Words 1: Choosing the words: synonyms Unless core to the talk topic, or used for dramatic emphasis, it is best not to repeat words too often in a speech. The use of varied terms can enliven a speech and suggest a breadth of knowledge in the speaker. Although it needs to be used judiciously, varied ways of saying the same thing can certainly reinforce a message. Lederer (2007) quotes a San Diego zoo sign that uses synonyms to good dramatic effect: ‘Please do not annoy, torment, pester, plague, molest, worry, badger, harry, harass, heckle, persecute, irk, bully, rag, vex, disquiet, goad, beset, bother, tease, nettle, tantalize, or ruffle the animals.’ The use of the thesaurus – whether in book or desktop form – can be valuable for clients writing presentations that need to have a strong impact.

Words 2: Choosing the words: monitoring adjectives The odd image has power but it is important not to use too many descriptive words because these can over-emphasise or sentimentalise a point. The rule is often ‘keep it strong and simple’. Writing about her editing work on a book about post-war camps for displaced people, Diana Athill (2000) describes her recognition that they ‘must use no adjectives – or very

Voice Work: Art and Science in Changing Voices. Christina Shewell © 2009 Christina Shewell. ISBN: 978-0-470-01992-4

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few. Words such as horrifying, atrocious, tragic, terrifying – they shrivelled like scraps of paper thrown into a blazing fire.’

Words 3: Choosing the words: jokes and quotations Some public speakers skilfully incorporate jokes and entertaining quotations into their talks, and newer presenters sometimes ask a voice coach how they can learn to do the same. People vary in their natural skills of entertainment or comedic skills, and in their particular kind of humour. Practical training will explore an individual’s own style, but exposure to new ideas and practice can unleash previously untapped abilities. It can be useful to work with a book of quotations or jokes. I ask the speaker to choose three examples that appeal to her, and to deliberately insert them into three carefully constructed paragraphs connected to her talk topic. She tries them out in the safe training context, and we discuss how they worked and what might work better. The speaker experiences how it could be done, and can take things further if she wants. Quotes or jokes may be rehearsed alone, but they should always be tried out on at least one other person before use. They are usually best just ‘slipped into’ a speech. Introductions such as ‘I heard a good joke the other day . . . ’ or ‘I’d like to quote . . . ’ tend to defuse the impact, and listeners may tense if they sense that what is coming may not be at all amusing or entertaining. Practising a new word choice in an artificial exercise with a trainer works well in rhetorical devices and stories; the aim is to extend a person’s ‘box’ of speech skills, so that he can incorporate new ideas to enliven any speech.

Words 4: Choosing the words: rhetorical devices. Many of the best speeches are straight, strong and simple, and need no ornamentation. ‘Rhetoric’ has become associated with insincerity (e.g. ‘It’s just empty rhetoric’) but a carefully chosen clever phrase can be memorable, as we see in politics and advertising. Rhetoric has long been valued by many societies, but its teaching is no longer part of general education. The terms below are likely to be unfamiliar to most readers, and are included in the spirit of stimulation rather than instruction, because they demonstrate some of the options for word choice. There is no suggestion that every speech should contain such a collection, and such devices must never be over-used; one or just possibly two per 15-minute speech is quite sufficient. They can, however, be fun to explore in presentation development, and one of the devices may produce something of value in a speech. 1. Antithesis: contrasting ideas expressed in parallel or symmetrical phrasing: If we act now the sky is our limit, but if we hesitate, we will hit the ground hard.

2. Assonance: the repetition of vowel sounds; alliteration: repetition of consonant sounds: Our competitors’ selling style may well be smooth, cool and oozing with charm, but our honest clarity can direct and delicately drive our clients towards the decision they truly want to make.

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3. Pictorial image: a vivid sensory image: She was a Quaker lady who was noticed to turn the other cheek with a ferocity that nearly knocked you over. (Ronald Higgins, personal communication, 2002)

4. Litotes: understatement for unusual or comic effect: Our telephone sale profit of £15 million suggests that those calls have not entirely been a waste of time.

5. Paradox: apparently contradictory but illuminating images: The ropes that limit us are made of cobwebs, but have the complexity of the tarantula behind them.

6. Epizeukis: emphatic repetition: Although the hands of the clock tick on, we do have time – time – time – time itself on our side. We can wait.

7. Cacophony: harsh or discordant phrasing: Our colleagues are using various devices to attract investors – they are jabbing, cajoling and clattering their begging bowls. We need none of this.

8. Epistrophe/Antistrophe: repetition of words at ends of phrases: It is the vision of the nurses, the stoicism of the nurses, the extraordinary, endless, energetic day-by-day energy of the nurses that keep this hospital running.

9. Oxymoron: the juxtaposition of two contradictory words or images: If we two companies tie our shoelaces together, we will actually run faster in the technology race.

10. Brachylogia: abbreviated expression: So – we build on the successes of the previous year. Greater production, more sharing of ideas, fewer limitations. Growth without duplication.

11. Anaphora: repetition of words or phrases at the start of sentences or clauses: We will listen to our clients. We will listen to our competitors. We will listen to the media. Above all we will listen to each other.

12. Metonymy: use of a single term to express a wider concept: We are delighted to see our new director’s nameplate on the door.

Words 5: Choosing the words: stories in speeches Stories are part of our heritage and our lives and, until the advent of printing, were the way that history was recorded and passed down through time. Research shows that, if you are told two stories of comparable length containing a comparable number of facts, but one has a much higher emotional content, listeners will remember far more detail from the

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emotional story than from the other (Damasio 1999). Nothing informs like a story, and the use of a well-chosen narrative can give a memorable illustration and new energy to even a long factual speech. I am not referring here to myths and fiction (though some speakers use these with great effect), but to the simple narration of a presentation-relevant story. We tell stories every day as we describe the happenings of our lives to others, but people vary in their willingness to tell a story as part of a public presentation. Practising in a group increases skill and confidence and often stimulates speakers to incorporate a relevant story into their next presentation. There are many varieties of story telling exercises; those below are paraphrased or adapted from Rodenburg’s (1993) wide range of ideas for connecting the voice to the text. She calls them ‘playtime for the language muscles’ and they are included here with her permission.

5.1 Sound story Each group member thinks of a very short and simple story that they could tell in sounds only (usually around a minute). They can repeat and emphasise any of the sounds, and use as much dramatic pause as they like. On one workshop a senior manager used sound to describe his experience of strong winds and high seas as he sailed with two friends. They heard the main mast break, tried to radio for help, found this was out of order, and effected a temporary repair with nails, rope and thick tape, while yelling instructions to each other as the wind blew stronger.

5.2 The seven-word story People tell a story of something interesting that has happened to them. They are only allowed to use seven words, but each can be repeated as many times as the speaker wants. A listener can then tell the story back to the speaker, so that he can hear what has been conveyed.

5.3 Two-minute story in short or long thoughts Ask the client to tell a story alternating long thoughts with short thoughts, e.g. ‘It was cold. All warmth had long left my hands and even my sheepskin gloves offered little protection against the wind. Ten degrees below. I had never known such cold in the moderate English climate. I loathed it.’ This helps give a speaker the idea and feeling that a speech will have its own rhythm, that awareness may affect the preparation of his own material later.

5.4 Describing the route from home to work Ask the speaker to tell the group exactly how to get from his home to work, e.g. ‘Go out of the door, round the back of the house and get into the car’. He speaks each sentence to a different group member, using a different emotional ‘tone of voice’ for each instruction, e.g. emphatic, relaxed, frightened, humorous, edgy. Each listener has to repeat the instruc-

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tion back to the speaker in the same ‘tone of voice’, at which point the speaker says enthusiastically ‘that’s right!’ and moves on to the next sentence.

5.5 ‘I don’t believe you’ exercise. The speaker tells a story or delivers a brief speech. Every so often – and it needs to be often – a listener calls out ‘I don’t believe you’, and the speaker needs to express extra conviction in her speech as she repeats the statement.

Words 6: Choosing and filling the words: haikus. The haiku is an old Japanese poetical form. There are different forms and rules; one of the simplest has three lines of words, with a total of seventeen syllables. The first line has five syllables, the second seven and the third five. Haiku writing can be used as part of work on word choice and sensitisation. Working with varied groups, including actors and business people, I show examples of haikus as a simple form to express a clear thought, memory or image. There can be a great satisfaction in selecting exactly the right words to fit both structure and idea, and this mirrors the art of speech writing. These are a few examples written by some musical theatre students during a class that explored concepts of romantic love and war. Most had not written poems since childhood: It is not profound. There are no trumpets playing. It is very quiet. Hop, skip, jump, happy thinking about you – remember that day? Secret affections with passionate advances. What a great hobby! War brings hurt and pain, destruction and fear remain, innocence now lost. Bullets are flying hot metal piercing the air. Stand up if you dare.

Words 7: Filling the words: voice quality mirrors meaning This is best done in a group. As people move round the room, speak a number of words out loud, one by one, and have them explore how their voices can mirror the meanings.

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Some examples: knife, tiger, wind, soft, moon, robbery, office, run, crash, enliven, squidgy, sexy, frightened, courageous, laugh, deny, stop, love, icicle, rabbit, skyscraper, accountant – and so on. A list similar to that in Box 25.1 could be used.

Words 8: Filling the words: other exploration ideas Voice teachers use a variety of exploratory voice ways to help the actor to connect to the words with which he is working; Berry, Houseman, Linklater and Rodenburg describe many ideas in great detail. Some of these are relevant for the singing teacher who is developing students’ sensitivity to song words. These are examples of a few core exercises; all move a speaker away from purely intellectual text analysis into visceral and sensory aspects: • • • • • • • • • •

Mouth the words. Whisper them. Sound out their consonants only. Sound out their vowels only. Speak only the action words. Speak only the nouns. Speak only the words that relate to a particular idea important in the text, or play. Intone the words on one note. Sing the words in made-up melodies. Physically enact the words, allowing arms, legs, posture, body shape and movement to express the feeling of the words. • Speak one word at a time, allowing a pause after each one to let it ‘sink in’, so that you feel its sound and its meaning. • Speak only two words at a time, gradually moving through the whole text. Feel the connection between them. The first haiku above would be spoken as: It is – is not – not profound – profound there – there are – are no – no trumpets – trumpets playing – playing it – it is – is very – very quiet.

Although primarily actor exercises, it is possible to adapt some of these for work with the right person or group in the worlds of teaching or business. For example, let’s say that a client speaks the line ‘we need to listen to our customers, we need to note what they say, put it in writing, and act upon it’. We could ask him to select the core words and explore them vocally; this might move him into a more vivid way of speaking, e.g. ‘Listen – note – act. Three bricks of the foundations that will build us up again.’

Words 9: Filling the words: body work to explore the feeling of words This is a deep exercise to explore the sound and feeling of words or phrases. It is best learnt in a practical session, and generally more suitable for performers than other groups of professional voice users.

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Box 25.1 Plosive initial words for sounding and moving Ball-boy Babble Baby Back Backscratch Backbreak Bacteria Bad Bald Band Bandit Bank Barber Barmy Barndance Barnowl Basket Bassoon Bastard Bawdy Beaker Bed-sit Bedecked Beesting Beeswax Behold Bemuse Bench Bend Beretta Beret Bermuda Berlin Bestow Bicycle Bikini Binocular Bitter Black Blame Blind Block Blue Bluster Boat Body Bodybuilder Bomb Boomerang

Pagan Pain Painting Panic Panting Panpipe Paradise Papoose Paprika Parched Pastoral Patriarch Payment Pea Peccadillo Peck Pencil Penance Pergola Perhaps Permeate Pernicious Perforate Perplexed Personality Piano Pick Picture Pig Pigeon Pill Pillar Pip Pipistrelle Pistol Piston Pit Pitchfork Poison Polar bear Polite Politician Pollywog Pomp Popular Poser Posh Poseidon Post Potato

Dam Damage Dance Dabble Dapple Dark Dartboard Dash Daisy Dawn Day Daydream Dead Decision Deck Dear Define Defend Definite Degrade Demon Dentist Dent Dependable Describe Desk Desire Dew Dice Dick Die Different Difficult Dilute Dilapidated Dilute Dim-witted Dinner party Dinosaur Disco Dismay Dislike Dive Do Doctor Dictator Dog Dopey Doom Dumb

Tag Tacky Tail Tambourine Tapeworm Tarradiddle Taskmaster Tassel Tea Tea cosy Tearful Tearaway Teacher Technicolour Teddy bear Tedium Television Telltale Temptation Tent Tennis Tense Terror Test pilot Testosterone Text Tick Tidal wave Titanic Tiddleywink Tidy Tiger Timber Tilt Time Tin can Tiny Tingle Tiptoes Tit Tittle-tattle Toad Tobacco Top Touch Tough Tummy Tune Turbocharged Turbulence

Gabble Gaga Galaxy Gallop Gambol Gamble Game Gangly Garage Garam masala Garden Gasp Gone Gassy Gateway Gather Gaudy Gawp Gay Gazump Geiger-counter Get-together Giddy Give Go Goal kick Goat Gobble Gob God Gold Gondola Goodnight Goofy Goosebumps Gory Gorgeous Gorge Gotcha Gourmand Guess Guest Guide Guilty Gullible Gulp Gum Gunshot Guzzle

Cabbage Cage Call come Cake Camping Cannibal Canary Car Cardamom Carnival Cast Castle Cat Cauldron Cavalry Cavity Cavort Coat Court Cock Cohabit Cold Collect Collywobbles Comb Comet Common Communicate Concern Complete Concert Concussion Condolence Condom Conga drum Conjuror Conker Kangaroo Kettle Key Kick Kill Kiss Kidney bean Kinship Kimono Kind Kipper Kitchen

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Lie down on the floor. ‘Breathe’ a word in, imaginatively taking its shape and emotional feeling into your mind and body. Whisper the word a few times, feeling its shape in your mouth and lips. Then just mouth it. See how it feels and tastes. Then let the word affect your body. This may just be in your imagination, but it may stimulate a small or big movement. Take time to let this develop; you can mouth, whisper, speak or sing the word while moving. Say it in a variety of ways. Stand and see how you might speak it quite loudly. What pitch does the word have? What sound qualities? What energy? Put the word in a sentence and walk that sentence round the room.

Speech sounds The practical ideas for lips, jaw, palate and tongue work in Chapter 20 are all warm-ups for work on vowels and consonants. The exercises in this section focus on the speaking of specific speech sounds. They are not designed for specialised therapy with communication disorders (e.g. specific language impairment, cerebral palsy or dysarthria) but can be adapted accordingly.

Speech sounds 1: Identifying the place and manner: sound sensation It is important to take time with your client to identify exactly where and how the sounds on which you are working are made in his mouth, e.g. as we saw in Chapter 9, speakers vary as to whether they produce /t/ and /d/ with the tongue tip or with its front. Provided that the sound is clear and causes no problems in the sung voice, those individual variations should be left alone; changing places in the mouth takes huge commitment.

Speech sounds 2: Working to establish new neuromuscular patterns: incorporating the articulation into ordinary life If any sound is difficult to make, it will need to be practised intensively on its own, before being included in words. Point out the need for regular practice; as the client goes about her ordinary life activities, she can frequently and repeatedly (silently or audibly if appropriate) make the speech sounds.

Speech sounds 3: Clear consonants: consonant plus vowel combinations In this exercise, a variety of consonants is produced with a variety of vowels, in different places, i.e. word initial p-ah, word final ah-p and mid-word ah-p-ee. Write down a list of all the consonants on which you are working, and then make a list for the client with those sounds placed with different vowels. Comprehensive lists are included in both Turner (1950, 2000) and Berry (1987).

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Speech sounds 4: Clear consonants: word lists Clients working on specific speech sounds are often given lists of words to practise. Repetition is of course necessary, but simply reading aloud can be a dry and boring process. Word lists can be used in a number of ways to encourage as much of the play element as possible. Here are a few ideas. This list involves only the word initial sounds /b/, /p/, /d/, /t/, /g/, /k/; you would obviously make your own relevant lists: • Repeat two or three words over and over again with different rhythms. • In partners in a group: acting ‘as if’ playing table tennis, use your hands to bat first the speech sound ‘rah, rah’ to each other, and then pairs of words ‘reach rook, reach rook, reach rook’, etc. Feel the energetic muscularity of both arm and speech sound movements. • In a group: have the group move around the room, with loose and easy bodies. Speak one of these words out loud, and ask the group to repeat this in as many different ways as possible, exaggerating and relishing the sounds. Allow a few minutes and then move onto another word.

Speech sounds 5: Clear consonants: song words Song words can useful as texts for practising speaking with an exaggerated clarity of consonants; the rhythmic structure and clear phrasing provides a clear framework into which the sounds can be crisply ‘slotted’. Use songs that are familiar to the individual client, whether traditional folk songs, pop song lyrics, nursery rhymes or hymns. A client’s knowledge of the music is likely to affect the length of vowels, rhythm and pitch changes in her spoken voice. Some audience members become very irritated if they cannot hear the words sung by a choir, whereas others simply sit back and enjoy the overall sound. I take the view that song words should be audible. If a choir is required to read out loud the words of a new song several times with exaggerated vowel and consonants, before singing it, the clarity of those sounds is more likely to be stored into muscle memory. They are then more likely to be produced with energy and precision once the song is sung.

Speech sounds 6: Clear consonants: tongue twisters Tongue twisters have long been used to establish clear articulation of speech sounds, and Ken Parkin’s Anthology of British Tongue Twisters (Parkin 1969) is an excellent collection. I tend to use ‘fast talk’ (see Speech sounds 13 below) more than tongue twisters, but they can be useful for an individual to practise alone. The accompaniment of singing or movement keeps them slightly more interesting! • Sing up and down a scale on any one of these: banoffie pie; Gina Lollobrigida; caterpillar; copper-bottomed coffee pot; red lorry, yellow lorry; Peter Piper picked a peck etc. • As you walk, speak a tongue twister seven times, increasing the speed of your movement each time it is said. Keep the energy of speech muscle movement and clarity of sound.

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Speech sounds 7: Shaping the vowels: whispering Whispering poetry or prose texts can allow us to feel the sensation of the consonant and vowel shapes in our mouths.

Speech sounds 8: Shaping the vowels: ventriloquism Speak this as if you were a ventriloquist, with no lip movements. Be aware of the hard work that your tongue will be doing to shape those words: How now round cow Why do you look so sad? How now round cow You ought to look gay and glad. Down on the grassy ground I found you Drowsing with crowds of cows around you How now round cow Why do you look so sad?

Then do it again, with as much lip movement as you like, but still keep that awareness of the amazing range of tongue movements involved in vowel shaping.

Speech sounds 9: Shaping the vowels: booming the resonance Speak these words/nonsense syllables in the most resonant ‘booming’ sound possible (without throat strain or excessive loudness). Make the vowel sounds long, and let them go out to different parts of the room around you. Hear and feel the difference in the shapes of the vowels and diphthongs. Hoom horm harm herm heem hum hem him ham hom hame hime home hoim

Speech sounds 10: Shaping the vowels: vowel sound and word Use a list of words with different vowels. Taking each word in turn, first speak its vowel sound several times, and then the word itself, and then again the vowel alone, e.g. if the word is sweet, the vowel ee is intoned and spoken several times, then the whole word, and then again the sound ee. Hear and feel the vowel sound, and how it sounds in that word. Take time to explore it.

Speech sounds 11: Feeling the vowels: links to the chakras Chapter 19 introduced the concept of the chakras. Some traditions link these to different vowels and these can be explored in an imaginative voice exercise.

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Lying down or sitting, take the time needed to focus attention and breathe into the body. Take several minutes for each vowel sequence: • Lower back: imagine breathing into this place. Hum ‘into it’, and then imagine the hum flowing up through your body and out of your mouth. Let the breath drop into your body whenever you need it. Intone a long oo sound, letting your voice go into any pitch or quality that you like but keeping that same vowel shape at all times. After a few minutes, speak some words that contain that oo vowel, again exploring different voice qualities. • Just below navel: repeat the sequence but this time the vowel sound is aw. • Heart: with the vowel sound ah. • Throat: with the vowel sound er. • The top of the head: with the vowel sound ee.

Speech sounds 12: Exploring vowel and consonant: character styles (This is based on Grotowski [1975]: ‘diction is a means of expression. The multiplicity of types of diction existing in life should also be found on the stage.’) Take a short piece of text and speak it in several different ways, allowing the speech pronunciation to suggest caricature versions of different characters, e.g. an elderly dictionary compiler, a very shy 8-year-old girl, an aggressive politician, a food-obsessed diner, a soaking wet fisherman. This can also be done in pairs as an imitation exercise, with one partner imitating the other.

Speech sounds: 13 Clarity and agility: ‘fast talk’ Read a text out loud, seeing how quickly you can speak it with very energetic movements of jaw, tongue and lip muscles. Your face should look odd while you do this! Carry on for at least 3 minutes; the articulation muscles should really feel ‘worked’ after this exercises. The piece below is fun to do, but you can use anything from a telephone directory to a novel extract. Make sure that there are no pronunciation difficulties, because this will inevitably slow the speed down: When You’re Lying Awake. Sung by the Lord Chancellor in ‘Iolanthe’ (libretto by William S. Gilbert) When you’re lying awake with a dismal headache, and repose is tabooed by anxiety, I conceive you may use any language you choose, to indulge in without impropriety; For your brain is on fire – the bedclothes conspire of usual slumber to plunder you; First your counterpane goes, and uncovers your toes, and your sheet slips demurely from under you. Then the blanketing tickles, you feel like mixed pickles – so terribly sharp is the pricking, And you’re hot and you’re cross, and you tumble and toss til there’s nothing twixt you and the ticking. Then the bedclothes all creep to the ground in a heap, and you pick ‘em all up in a tangle; Next your pillow resigns and politely declines to remain at its usual angle.

388 Voice Work: Art and Science in Changing Voices Well you get some repose in the form of a doze, with hot eyeballs and head ever aching, But your slumbering teems with such horrible dreams that you’d very much better be waking. You’re a regular wreck, with a crick in your neck, and no wonder you snore for your head’s on the floor, and you’ve needles and pins from your soles to your shins, and your flesh is acreep for your left leg’s asleep, and you’ve cramp in your toes and a fly on your nose, and some fluff in your lung, and a feverish tongue, and a thirst that’s intense, and a general sense that you haven’t been sleeping in clover; But the darkness has passed, and its daylight at last, and the night has been long, ditto ditto my song – And thank goodness they’re both of them over!

If a client has any reading problems ask her to use serial speech, nursery rhymes or other learnt material. She should then talk about something at that speed and muscle energy. After a few minutes, ask her to talk normally to you about something, but with a new awareness of the potential agility and flexibility of speech muscles.

Pace Pace 1: Tuning into pace: the imaginary speedometer Establish with the client an imaginary 1–10 speedometer scale where 1 is abnormally slow and 10 is as fast as possible. Draw this on a piece of paper. Discuss with her where she would place her habitual speed and, using a real sentence that she has just said to you in the course of conversation, practise it at different speeds. Discuss how they feel different, both intellectually and in sensation. Depending on whether her overall pace is too slow, or too fast, settle on a number just one above or below the habitual speed and practise that in counting, reading and speaking. If a client is highly motivated to change her speed, she can write the desired number on her hand so that she can notice this while speaking.

Pace 2: Changing the pace: walking the talk As the client talks with you, or does a presentation, stop him in mid-flow and ask him to repeat a few lines again. As he does so, you walk around the room at the speed and rhythm of his speaking. Have him mirror you as he goes on talking. Then ask him to slow down – or speed up – the movement and the ensuing speed of speaking.

Pace 3: Pace variety: alternating speeds • Have your client read out loud, alternating each sentence spoken between fast and slow speeds. • Then, as he reads, say one of the speedometer image numbers and have him read at that speed. Change to another, and so on.

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• Then have him read the whole text varying the speeds quite randomly as he wills. • Finally, ask him to make a short speech, consciously varying the speed in a way that is appropriate for the meanings.

Pause Pause 1: Taking the space: holding the silence (This can be powerful if done between client and practitioner, but is most effective if done in a group context.) The group sit on chairs, facing an empty space or platform. Each speaker in turn walks slowly into the space and faces the rest of the audience. He should stand symmetrically, arms by his side with weight evenly spaced on his feet. He stays there in absolute silence for as long as he can bear, making eye contact with each person in turn. He should be as still as possible with a neutral or just slightly interested facial expression, and try not to fidget, sway, glaze over, smile, laugh or ‘placate’ the audience in any way. The group needs to sit very still with calm but friendly faces; they should not break eye contact with the protagonist nor try to make him laugh. The person can stay on that ‘stage’ for as long or short a time as seems possible, before quietly returning to his chair. Very occasionally a speaker enjoys the sense of silent power so much that they stay so long that the practitioner has to signal that time is up! This is a demanding exercise, but it goes deep and can be memorable. It is hugely challenging to be looked at by a group without the shield of words or placating facial expression, but enables a person to go into that fear, find his still point and emerge stronger to speak in front of others. If there is time in a group, it is valuable to repeat the exercise because people usually exceed their previous staying power and feel satisfaction from that. It is a bit like being on a roller coaster – the first time is terrifying, the next is almost enjoyable and the third is positively exhilarating! Note that there are many variants of this exercise in the acting tradition, and as ‘relational presence’, it one of the techniques of the excellent Speaking Circles network.

Pause 2: Testing the silence: extending the pause Explore with listeners how long they feel they can acceptably pause between two sentences such as: There is only one thing we can do. PAUSE. We must let him go. If the government does not act now, what will happen? PAUSE. Disaster. Surely you’ve guessed my darling? PAUSE. I adore you! You’ll never guess who I’ve just seen! PAUSE. [Have your client choose a name that really does excite her.]

Time the pause in seconds, and give feedback as to whether it could be longer. Have the speaker try again, increasing the pause length and aiming for beyond the maximum that

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feels possible in a particular context. Repeat a number of times, so that a new implicit memory awareness of potential pause develops. Encourage the speaker to enjoy that feeling of silent power as the listener waits.

Pause 3: Feeling the pauses: walking the thoughts Have the speaker read or speak his speech, walking around the room as he says a thought. When he feels that a pause might be possible (they will not all be used in actual delivery) he should physically stop – and only start walking again as he begins again to speak the next thought.

Fluency If there is any concern that a fluency problem might be a stammer, sensitively explore the possibility that the speaker might consult a specialist speech and language therapist. Many public speakers fear ‘drying up’ in the middle of a talk, when a pause for thought becomes wordless terror. The management of both the fear and the reality is a usual part of presentation skills training; all work done on the preparation of material and the control of nerves is designed to help. It is often important for the speaker to learn to trust that a short pause for thought, or to look at notes, is perfectly acceptable. The pauses and ‘filling’ sounds of normal non-fluency become a problem only if they worry the speaker or irritate listeners. Sometimes a speaker is unaware of his hesitations, and a voice trainer has to point them out. If pauses are too long, direct work will aim to enable the client to experience speaking in a flowing non-stop way. There are many exercises for improving fluency and the ability to ‘put things into words’; these give an idea of what is available.

Succinct story telling Tell the client a story and have him tell it back to you, quickly and as fluently as possible. If he pauses too long, he should retrace his words and have another go.

Speaking on the spot Give the speaker a topic and have her speak for a minute as fluently as possible. Count any intrusive pauses; discuss the total at the end of each minute talk, and immediately move straight onto another topic where she sees if she can lessen the number of interruptions.

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Challenging speech Ask the speaker to tell you a story of something. After a few sentences pick up on something that he says; interrupt and say ‘never mind that, tell me about the X’ (where X is any word that he has mentioned). The speaker has to change direction and to continue by describing that object, idea, person or happening, until you interrupt again with another demand.

Changing a filler sound Listeners are usually irritated by a too frequently repeated filler sound such as um or ur. Having worked to encourage general fluency, we can work directly to reduce or change that interruption.

Voice story: Nigel Nigel was a lecturer who regularly used the filler ‘um’ in his speech; he was aware that this irritated his students, as he had over-heard a critical comments. I pointed out that ‘um’ is a noisy pause made with lips closed, and encouraged Nigel to inhibit his habit of lip closing in silent thought as he spoke. In our session, he practised deliberately letting his lips half-open as he stopped to breathe or think in mid-flow. Care was taken that the open-lipped ‘ur’ was not substituted instead. After 4 weeks of intensive practice, Nigel broke the habit of intrusive sounds; although he still paused at times, his speech was significantly more fluent.

Rhythm As described in Chapter 14, a mixture of voice aspects – emphasis, pace, pause, the length of words and sentences, pitch changes and the flow or fluency of the words – make the rhythm of speech. Work on these areas should affect the overall rhythm of the way that someone speaks or reads. A specific focus on rhythm can be made through discussion, increased awareness and some simple exercises.

Physical exploration of rhythm Choose a piece of text that is suitable for your client or group, and explore the rhythm of its sentences in different ways: 1. Clap the syllables of the words and sentences. 2. Step the syllables around the room to feel the rhythms.

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3. Shake a hand in time to the rhythm of the sentences – or use any other body movement. 4. Use the sound mm to hum the rhythm of the sentences of a piece of text.

Comparing written language rhythms Any play or poem text can be explored by using these exercises; many acting students first feel and hear the iambic pentameter of Shakespeare’s verse by such exploration. But there are also rhythms in prose, and these too can be experienced in practical work. Choose five opening paragraphs from five different novelists (chosen to be well contrasted). Ask the client to read these out loud and to explore the different rhythms, using the practical exercises above. See if he can find words or images to express the different prose rhythms. Then see if he can write a few sentences in that same sort of rhythm. This can be a very interesting exercise for writers or literature students, as the internal ‘pulse’ of the language suddenly appears.

Making meaning clear through good use of rhythm, pace and pause Source unknown: text from a course participant in 1986. In defending my client against the charge of libel I shall show that the article was not written by Jones. Or if it was, the passages in question were not. Or if they were, he did not mean them in the plaintiff’s sense. Or if he did, the passages in question had substantial truth. Or if they had not, my client did not and could not, at the time, know them not to be true. Or if he could and did, we could not then, and cannot now, know them to be untrue. Or if we can and could, and he could and did, and they had not, and he did, and they were, and it was, then my client is not Jones.

Chapter 26

Group voice exercises

Many people who would never sing solo in public regularly extend their voices with pleasure and energy within a choir. It can be the same in a voice workshop – some people who are inhibited by a one-to-one session make imaginative leaps of sound in the safety of a group. Here they can explore their voices as part of a whole, and give and receive valuable peer feedback if they find the confidence to be heard ‘above the crowd’. Collective voice classes are core to actor training, singing students often attend ensemble classes alongside their individual lessons and practical workshops may supplement individual voice therapy. Any voice practitioner may lead a group workshop and this chapter offers a number of ideas for voice exploration in that context. They supplement the many exercises in the preceding practical Voice Skills chapters that can be adapted for group work. Running a voice group is challenging, and the confidence and skills of the leader are crucial to its success or failure. Timing, keeping a good flow and progression, choice of material, an ability to improvise, dealing with the emotions of the individuals and the group dynamics, the ability to pick up crucial factors of voice or physical use and even remembering names – all need practice. It can feel like a combination of playing the many pipes of an organ and choreographing a group dance. Most of us learn ‘on the job’, and most of us will have some awkwardness in the early days of group running. There are hundreds of possible exercises for voice groups; the voice literature offers ideas that can be adapted for the collective, but equally relevant are the drama books on games and improvisation. As always, the best way to extend skills is to go on every available experiential voice workshop to learn from others. The voice practitioner has to be particularly careful when leading a voice group. We have to make it clear that, as we cannot see what every individual is doing or feeling, group members have to take responsibility for their own wellbeing. They need to be told that they can stop at once if anything is physically uncomfortable or too emotionally disturbing. In work with a partner, people need to be careful with physical movement and sensitive if anything appears to be troubling the other person. When planning a group session, new practitioners usually need to make an explicit structure for what they want to achieve and the activities to make this happen. Exercises need to be suitable for the size and acoustic atmosphere of the working space and for the group

Voice Work: Art and Science in Changing Voices. Christina Shewell © 2009 Christina Shewell. ISBN: 978-0-470-01992-4

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members; alternative versions of a task should always be possible for inactive or disabled members. Having a plan gives you confidence, but, once embarked upon by the group, you are likely to find yourself improvising activities that are probably better than your plan. Eventually you may go into a group with nothing written down at all – it will all be within you. These exercises are organised under three overlapping headings. Although they loosely follow the order of the eight Voice Skills, no ordered sequence is intended. Any exercise may offer a participant an unexpected voice connection or insight into an aspect of his own vocal story. You will therefore not find specific aims – just names and descriptions. The ideas are a miscellany from which you can select appropriately for a particular group. Choose with care – some of the exercises in this chapter require high levels of fitness, whereas others need considerable ‘sound bravery’. All need to be carefully supervised. 1. Warm-ups. 2. Specific aspects of voice work. 3. Sound improvisations.

Warm-ups Group 1: Learning names: musical stopping With or without suitable background music, ask the group to walk around the room, enjoying the novelty of walking without specific aim or direction. When you signal, or the music stops, they speak their own name to a person nearby, repeat the name that is said to them and walk on.

Group 2: Learning names: introduce a partner Sit people in a circle. Ask them to turn to a person next to them (so there are a number of pairs). They should find out each other’s names and something about their partner – a surprising fact, something she likes to do or why he is at the group. After a few minutes, have each group member introduce his or her partner, with that extra fact about them. ‘This is Ruth and last weekend she jumped out of an aeroplane at 5000 feet.’ The group looks at Ruth and says her name. Move round the circle. Note: the physical format of the circle shape for work is not always comfortable for new group members because it does mean that the entire group look at each individual member, who has to make eye contact with most or all. Be aware of this. It may be appropriate to do ‘round the room’ or partner warm-up work before using the circle.

Group 3: Learning names: saying own and partner’s name round circle The group sits or stands in a circle. Ask everyone to learn the name of the person on his or her left. Go round the circle, starting with yourself and say: ‘I am Louise, this is Robin.’

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The whole group says: ‘Hello Louise. Hello Robin!’ Robin then speaks his name and the name of the person on his left – and so on. Once the circle has been completed, do the same thing with the name of the person on your right.

Group 4: Learning names: group echoes voices The group looks at each member in turn as that person says his name with a particular voice quality. Once spoken, the group echoes back the name, trying to capture that same voice quality. This can be done with speech alone, or you can ask each person to make an accompanying movement as he says his name, so the group imitate that as well. Allow this to go round the circle three times, so people have a chance to change their sound if they want – and to learn names!

Group 5: Learning names: throwing an object across a circle Throw a large ball, cushion or soft toy across to another group member as you say your name. Once all group members have done this, change the instruction so that this time you have to say your name and another’s name as you throw and catch. Make sure that everyone always makes good eye contact with the person to whom they throw. Finally, just say another person’s name as you throw the object to him.

Group 6: Warming up: ping-pong Standing in a circle, the leader starts by saying ping as she looks at the person on her left, who has turned his head to look at her. He immediately repeats ping as he quickly turns his head to his left to look at his neighbour. As soon as this person hears that ping, she turns her head to say it to the next. And so on. The idea is that the heads and voices move as quickly as possible, moving the sound around the circle. Whenever someone feels like it, they say pong, at which point the sound changes direction round the circle – until the next change with a ping – and so on.

Group 7: Warming up: word association In a circle, the leader clearly speaks a word as he looks at another group member, e.g. mouse. Person 2 repeats this word as he looks at another person, and adds any other word or sound that comes into his head, e.g. mouse–tail. Person 3 repeats that second word, with her own associated word association, e.g. tail–lorry – and so it passes across the circle. The idea is to move words as quickly as possible.

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Group 8: Loosening up: sound and movement in a circle Show the group a simple movement with an accompanying sound, e.g. you might stretch your arms above your head while saying a falling tone ‘aah’. Do three times, and each time the group members imitate your movement and sound as exactly as they can. Go round the circle with each member taking a turn to make her own sound and movement, which is then echoed by the rest of the group.

Group 9: Loosening up: walking or running, with sudden changes of direction Ask the group to move around the room and to change direction whenever you clap your hands, beat a drum, sing a note or give some other agreed signal.

Group 10: Meeting others: swapping movements around room Each person walks around the room, making a small repeated movement. At a signal given by you, the members stop to show their movement to another one or two people. The movements are ‘swapped’ so that each person then moves round the room with a new movement for a minute or so. The process is repeated several times, the control signal each time coming from the voice practitioner. A variation on this theme is to ask members to add the new movement to the one that they were doing, so that they build up a sequence. This can also be done with sounds.

Group 11: Loosening up the imagination: passing an imaginary object Pass another person an imaginary object, letting your face, hands, arms and body adapt to the image. Your neighbour needs to adapt to the feeling of what is passed onto him, because you will stress to the group that they do not need to know the identity of the imaginary object. He then allows his body movements to show that the ‘object’ changes and then gives it to someone else. It will continue to change as it moves round. If you sense that the group is enjoying this, introduce the idea of an accompanying sound – which will also change.

Specific aspects of voice work Group 12: Running, jumping, dancing – silence or music This can be a good way to start a group session. Play suitable pieces of music that will enable participants to physically loosen up in movement. The sound of music can provide

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a rhythm and reassurance background for active bodywork, rather than what is sometimes an embarrassed silence. The word ‘dancing’ can inhibit some group members so encouragement can be phrased as ‘just move to the music as you feel, as small or big as you like, maybe stretching, shaking out any tension, and seeing what other movements your body may discover it feels like making’.

Group 13: Body rub Ask people to rub different parts of their own bodies as you call out the names of those parts; start at the feet and work upwards through lower legs, knees, upper legs, stomach, buttocks, lower back, chest, hands, arms, shoulders and face. Then move around randomly with body part names. This can be done quickly and with strong energy, with people saying the names of each body part as they rub. You may also encourage the group to do it slowly and carefully, taking time to feel and appreciate the different muscles, in a simple self-massage. If members are comfortable with each other, this can be done in pairs with partners working to loosen up shoulders, neck and back areas. (Give some simple instructions to reassure those unused to such touch.)

Group 14: Shaking and shimmying Ask everyone to ‘shake through’ their bodies, letting some sound out as they do this. You can feed in some phrases for people to say as they do the action, e.g. ‘shake my legs, shimmy my shoulders, wobble my tummy/belly, wave my arms, undulate my spine, wag my butt, nod my head, point my finger, poke my chin, shiver my peculiars’. The choral directors of the Bristol Gasworks Choir have their singers warm up by rubbing parts of their body as they say ‘I love my arm, I love my lungs, I love my tummy, I love my kidneys, I love my throat, I love my butt, I love my legs . . . ’ as they rub (Dee Jarlett and Ali Orbaum, personal communication, 2005).

Group 15: Voicing from five parts of the body Tell the group that you will speak the names of five different places on the body – the groin, waist, heart, lips and forehead – and, as you do so, group members quickly and lightly touch each area on their own bodies. Slowly take the group through a sequence of moving up from lowest to highest point, one place at a time. As they rest a hand on each place, ask people to imagine the breath entering that area. Then they should ‘hum from that place’, then call ‘hello, hello’ from those positions, and finally speak the words ‘I like you very much’. Allow time for discussion of any differences experienced; they may be minimal or quite startling!

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Group 16: Exploring posture in movement Ask the group to walk around the room and to ‘tune into’ the relationship of different bits of their body as you call them out, e.g. head–neck; upper back–lower back, shoulders–upper arms, pelvis–upper legs and other combinations. Then ask them to walk with their upper body slightly leaning backwards, and to experience that pattern of body weight distribution; give them at least a minute to really observe how that feels. Then ask them to change so that they now lean slightly forward, and again observe that pattern. Finally ask them to move into something in between, i.e. a sense of balance with posture and a consciousness of a centre of gravity’. At the end of this 3- to 5minute exercise, have them talk to each other in pairs about what they feel is a habitual posture for them.

Group 17: Moving round the room with the focus on different parts of the body Ask the group to walk around the room, being ‘led’ by different parts of their body as you call them out, e.g. knees, nose, stomach, shoulders, upper chest, top of head, chin, feet, pelvis.

Group 18: Taking words into movement Ask people to walk in any direction that they like, changing direction when they like, but being aware of others to avoid collisions. Point out that it is rare for us to walk with no purpose, not carrying anything. This is a chance to feel the sensation of the body moving through space, and past others in a non-threatening way. As they move, you might direct people to briefly focus on different parts of their body, so that they gradually loosen up. After a while, tell them that you are going to say something, and their bodies will take on a quality of those words as it moves around the room. Give them around a minute to explore for each word or phrase, so that they have time to feel it. They then move immediately into the next body state as you name it. You can use any words that you like which are suitable for that particular group; a voice disorder group may feel safer with more concrete terms, but actors, singers and uninhibited students will be open to a wide variety of abstract words, including adjectives, colours or the elements, e.g. earth, air, fire and water. You can always become more esoteric as any group warms up! This exercise may be light-hearted but does get people connecting to their bodies, and moving in unusual and releasing ways. Here are some examples: • Movement words: galloping; hobbling; creeping; watching; jiving; washing; hopping; plodding; slinking; flopping; embracing; circling; slouching; leaping; flying. • Phrases: nervous hands; raised shoulders; wobbly hips; knock knees; worried face; ramrod spine; thrust pelvis; hysterical elbows; tired stomach; tilted head; exploding armpits; flabby thighs; saggy buttocks; excited mouth; electric hair.

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Group 19: Running and letting a word ‘drop in’ Ask the group to walk around the room, feeling a sense of connection to the ground until you signal a stop (by clapping, use of a drum or other means). When they stop, you speak a single word, and each person repeats as they take a few moments to ‘embody it’ (let it change their body posture or feeling in some way). They stay in one place for this exercise. You then move people on, and repeat the process. The words in this exercise are less geared to movement than the last one; they may be sensation words, or related to a text on which you are working or designed to take people on an imaginative journey.

Group 20: Inward–outward and levity–gravity Ask people to physically make themselves as small as possible, in whatever way feels right, and to hold it for a few minutes. They should observe their breathing, and ask to see any particular words that come into their minds, related to this position. Then ask them to move, stand and become as big as possible, spreading and connecting to an extravert, expansive aspect of themselves. Ask people to use small brushing movements to stroke up their bodies, from feet to top of head, and lead them in a stretch up on their toes with arms above their heads. Talk about the sensation of levity, the ‘rising’ energy. Then get them to use the brushing movements down their bodies from head to feet, and squat or kneel on the floor. Talk about the sensation of gravity, grounding and earthing.

Group 21: Partners mirroring (In partner exercises, I refer to A and B for simplicity of expression.) Get people into partners. With or without music, ask A to stay in one place in the room, but to move as they wish. B’s task is to copy those movements as exactly as possible. After a few minutes, have B take the leading role. If this goes well, introduce the idea of making sound as well, which is also mirrored. End this exercise with one partner standing symmetrically on his flat feet (no shoes), as the other person places her hands firmly on the top of his feet. He feels the pressure and imagines his solid connection to the ground – and breathes deeply. Change over. This exercise gets people watching and listening in a very acute way, and gives an opportunity to experience voices and movements that would not normally be in their repertoire.

Group 22: Round room jogging with sound Ask group members to jog around the room intoning a long aah vowel as they do so. Change to eeh and then ooh.

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This gives a chance for all group members to produce voice in the safety of group sound. If the group is for clients with voice disorders, stress that the sound should be quiet.

Group 23: Sound tag (For fit and active groups!) Appoint one person as ‘tag’ or ‘it’, and ask them to make a simple vocal sound as they run around the room trying to touch another. When caught, the next person chooses a sound and moves with it to catch another – and so on.

Group 24: Release work in partners B lies on her back, arms and legs flat on the floor. In complete silence, A very slowly and carefully lifts B’s arm from the floor, one hand round the wrist and one around the upper arm. Almost imperceptibly he raises her arm into a position about 6 inches/15 cm off the floor, holds it gently there for a minute or two and then equally slowly moves it back down to again rest on the floor. He then repeats the sequence with the other arm. This very slow limb movement can be surprisingly releasing. It is also an exercise in ‘trust’, so be careful with whom you use it. If the group know and trust each other well, legs can be lifted in the same kind of way. A should watch B’s breathing and quietly remind her to breathe if there are any signs of breath-holding, which often happens as limbs are lifted. Sighing is always welcomed!

Group 25: Partner work to connect to the deep TA muscle Ask B to stand, with a straight spine and loose abdominal area. If A gently pushes down on her shoulders, B’s spine will probably bend. Ask B to contract her deep transversus abdominis (TA) muscle; the shoulders and spine will be much firmer if A tries to push down again.

Group 26: Awareness of breath placing: hands on the back A sits or lies prone on the floor, or sits comfortably sideways on a chair. B places the palms of his two hands together flat at some point on the upper back, and tells A to ‘breathe under the hands’. She takes four or five easy breaths, focusing her breath into the place where she feels his warm hands on her back. B then moves his hands to rest on a slightly lower place on the back for another sequence of four to five breaths (Figure 26.1). He

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Figure 26.1 Breathing under a partner’s hands: lower back.

gradually moves down her back, with around five different placements. This exercise needs to be done in complete silence to allow both partners to focus on sensations. Touching the back for sensory breath work is relatively unthreatening, and can be used with most client groups. If a group is open to exploration and improvisation, this exercise can be done with partners prone on the floor. The hands can even move onto legs, arms and head, to enable people to explore how it feels to imaginatively ‘breathe into’ those parts. This may then lead into an improvisation of humming sounds from those places, which is a good body and resonance exercise.

Group 27: Group breath in a circle The group members hold hands or stand very close to each other with shoulders touching. All members blow a long stream of air out on a fff sound, directed at the centre of the circle. They then allow the breath to drop into their bodies and, again on the out-breath, blow it into the centre of the circle, trying to coordinate their breath so that everyone is

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breathing in and out at the same time. Great concentration and awareness of others are needed for this exercise. When it feels the right time, you can ask the group to intone a long mmm or aaa on each out-breath.

Group 28: Airing the quilt (From a workshop with Kristin Linklater.) In a circle, ask people to stand a little separate from each other, but not so far that they cannot hold hands, which you ask them to do. Ask them to imagine that you are all lifting a giant white cotton quilt, airing it by lifting it up towards the sunshine and down to the ground. From your place in the circle, lead them into raising their arms above their heads, letting the breath expand their ribcage as they do so. Then they slightly bend the knees and bring the arms down as the breath is blown out, to help dry the quilt. Repeat several times.

Group 29: Zigzag breathing (An exercise for a group who are physically comfortable with each other.) Tell people that they are going to make a group zigzag, to feel each other’s breathing. First ask one person to lie down in the semi-supine position. Another lies in that same position, with his head resting on the first person’s stomach. Then another lies in the semi-supine with his head on the second person’s stomach – and so it goes on until all are lying down with their heads on another’s stomach, making a long zigzag. Draw each person’s attention to the fact that they will be able to feel the rise and fall of the other person’s breath. After a few minutes, ask everyone to hum a low sound ‘as if’ from the stomach. People may feel vibrations and this usually leads to laughter at which point the group members feel the actual nature of the ‘belly laugh’.

Group 30: Building breath control in a group Ask the group to make increasingly long sustained ssh, fff and sss sounds, as they walk around the room, initially going at their own speed and length. Then tell them that you are going to count out loud in seconds as they start the sound, and will keep counting until the last person ‘runs out of breath’. Tell people to note at which number they run out of breath. Do this a few times, so that they can work to increase the length of their sounds. Then move into sustained voiced vowels or voiced fricative consonants. Ask people to speak a nursery rhyme, first of all just one line before a breath, then two, then three – until finally people are doing the whole four-line rhyme on one breath. If that seems easy, slow down the speed of the nursery rhyme!

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This sequence gradually builds up the muscular support for breath. I usually do it as people move around the room, to keep bodies loose.

Group 31: Playing with voices in simple rhymes In pairs, agree on a rhyme, and ask partners to say or sing it to each other several times. Then ask them to say it in ‘silly’ voices to each other. Then ask each one to say it in a voice that in some way expresses a series of imaginative situations, e.g. telling each other how to get out of a minefield, complaining about a faulty electric blanket, describing seeing a ghost, criticising an untidy house.

Group 32: Resonating ladder Demonstrate and then teach the group the resonating ladder exercise (Chapter 22, exercise 26), which changes the resonant quality on a long intoned vowel from head resonance to low chest resonance quality. Once people can enjoy their sounds and sensations, move straight into the next exercise.

Group 33: Advancing troops Place one half of the group on one side of the room, against the longer wall, and the other half opposite. Remind the group of the traditional war cries used for centuries by armies as they advanced on an enemy. One line of group members sits on the floor, and can choose whether to have their eyes open or closed. The other line walks slowly towards the sitters, producing a strong resonating ladder sound. As the advancing line gets close to the others, they should be in full booming chest resonance. For those sitting, the ever-closing sound can be felt as startlingly thrilling or rather intimidating – allow time for feedback.

Group 34: Sound baths A more pleasant listening experience is provided in the idea of sound baths. Have a few of the group sit back to back in the middle of a circle, with their eyes shut. The rest of the group members form a wide circle around them. At a signal from you, they advance on the sitting members, at the same time intoning a particular long vowel (ee, oo and ah work well) at a steady volume. As they reach those sitting, the ‘voicers’ raise their arms above the listeners, so that both sound and energy seem to gently cover them (Figure 26.2). They then retreat, still intoning, and repeat the movement and intoning several times. Move on to use different vowels; it is always interesting to discuss the different feelings that the listeners receive from the different vowels.

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Figure 26.2 Sound bath exercise.

Group 35: The ‘cosmic cow’ Move into a position on all fours, hands and knees on the floor. Demonstrate abdominal breathing in this position, showing how gravity encourages the stomach to go ‘bleeeagh’ as the breath drops in when needed. Talk about the big noble belly of the cow, and the fact that the sound of a cow lowing is not a polite little mmoo sound; rather it seems as if the deep sound originates in the belly of the cow, and echoes round before emerging into a sunlit field (or use words to that effect!). Then demonstrate your own deepest possible ‘echoing cow’ sound. Have the group copy you and, if fit enough, you can all move round the room for a few minutes on all fours, exploring the resonance of a herd of ‘cosmic cattle’.

Group 36: Group calls (Inspired by the work of singer and teacher Frankie Armstrong.) Have the group stand in a circle. Get everybody doing the same simple rhythmic movement (e.g. swaying in and out, miming an action with the arms). ‘Call’ a loud two-syllable sound

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to the group (e.g. hey ho) with a clear intonation pattern, coordinating that with the rhythm. The group responds by echoing that call back to you. Keep the movement going all the time. You can repeat that sound several times or move straight onto a different sound combination. Having demonstrated a number of sounds, pass on the leader role to the person next to you. She becomes the caller for a while – before passing it on. Any sounds are acceptable and, although it is challenging for some people to have the spotlight on them, sometimes even the shyest person finds a new energy as he leads the group for a few moments.

Group 37: Movement with vowels at changing pitches Have the group move around the room, varying their direction, intoning the long vowel that you give them. Everyone will be at different pitches, and that is fine. Ask each person to continue until they run out of breath and then to let the breath drop low into their bodies. They then start the same vowel again on a different pitch. When the time feels right, give them a new long vowel sound.

Group 38: Word sensitivity: drawing pictures Draw two pictures along the lines of those in Figure 26.3. Ask the group members to come up with made-up words for them. Once done, compare and contrast. Usually names for the spiky shape have very different sounds to those for the curved one. It can lead into a discussion about the way that the sounds of words may resonate with their meaning, and how in speaking we can connect to this through our voices.

Figure 26.3 Two pictures.

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Group 39: Word sensitivity: homophones (Adapted from poet Gerard Benson, personal communication, 1987.) Homophones are words that sound the same but have different meanings; they may or may not be spelt the same. So the word ‘plot’ can refer to a story, a piece of ground or a plan. In this game, a series of homophones are written on different cards. If there are three meanings, each one is written on a separate card and given to three different group members, e.g. ‘PLOT, as in a story’; ‘PLOT, as in a piece of ground’; ‘PLOT, as in a plan’. Each of the three in turn speaks the word ‘plot’ but tries to communicate to the group his particular meaning, simply by using his voice quality. (Miming and body gestures are not allowed.) Having heard all three, the group have to guess which was which. Some more examples of homophones: Miss: not to hit a target. Miss: unmarried woman. Miss: to long for someone. Mail: post. Male: man. Mail: chain-linked clothing. Down: not up. Down: depressed. Down: grassy space, often high up. Where: a question about place. Wear: clothing. Ware: goods Meat: animal flesh. Meet: to join company with. Meet: hunting get-together. Fast: quick. Fast: to eat nothing. Fast: secure.

Group 40: Word sensitivity: vowel sounds and emotions In a circle, make the sound of a vowel in a neutral manner. Each group member in turn speaks the vowel in any way that they like. The group quickly gives feedback as to the ‘feeling’ of each vowel made. Go round the group once on one vowel, then change it and repeat. This can be very difficult, but tunes people into the fact that sometimes sounds alone ‘say’ what words cannot.

Group 41: Sounding and moving words round the room (Adapted from voice teacher Lizzie Ingram, this exercise is deceptively simple; if well led and explored, it leads to a strong feeling of connection to the words, with resulting muscle clarity and energy.) You will need to compile a number of different words. They may relate to a play on which you are working, contain consonants on which you want to work, or be words with sensory or emotional meaning. Having warmed up the group in movement and other exercises, you tell them that you will speak the words out loud, one at a time. Group members move around the room, simply voicing each word a number of times, relishing and exploring all the consonants and vowels, and letting the word shape their movements. You will need to sense how long you allow for each word, keeping up a momentum of movement, while still allowing enough time for each word to be well experienced in the mouth and in the body.

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Sound improvisations In a sound improvisation the group leader creates a safe atmosphere where participants can extend their voices in a free-form way into qualities, pitches and volumes that may well be new and untried. Strong emotions can be brought out; the leader cannot know what will happen and needs to sense when to direct or end an exercise to protect voices, feelings or physical safety. Such improvisations offer some of the deepest experiences in vocal exploration, where people can let their voices move and develop in powerful and transformative ways.

Group 42: Chanting personal names Group members sit comfortably in a circle. They should close their eyes and quietly repeat their own names over and over again. Tell them that this initial quiet speaking can develop into speaking, chanting, intoning or singing in any way that might happen. Sometimes the exercise brings up strong feelings about both personal names and identity.

Group 43: The circling aah (From James Roose-Evans 1994.) Everyone stands in a circle, sides of bodies touching each other and with hands linked. It is best if people can keep their eyes shut. Tell the group that you will be making a shared sound, and they will need to stagger their breathing to keep it going. As leader, you make a long aaa sound and others join in, keeping the sound going ‘without interruption and without sagging’. The sound can be any pitch or quality but must say that particular aaa vowel sound. When it feels right, take one person by the hand and lead the whole line, hands linked together, into a series of spirals towards the centre of the circle, so that the group becomes close together and tightly packed. In this position they ‘can feel the sound resonating’ in their bodies. It can be ended in different ways; I open up the circle again and quietly go around separating hands, so that everyone is chanting alone before it dies down, or I use a simple bell as a signal to let the sound die away.

Group 44: Repeated intoned long vowel Tell the group that you will intone a steady long vowel several times, and that they should join in when they feel ready. They are free to let their note change in any way that they want. When everyone is intoning, you fade out your own sound but they continue for as long as the improvisation lasts. You can encourage it to fade away with a previously agreed signal, or rejoin the sounding, and intone more and more quietly.

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If appropriate for the group, members can then each intone a long solo vowel. Don’t comment on any sound, just move quickly onwards and go round the group at least three times so that people get used to the moment of lone sound. You may also suggest that people make the sound when they feel like it, so there is a spontaneity of sound making rather than the round-the-circle structure. If they are growing in confidence, you might suggest that they extend their arms outwards as they make the note, because this can help the feeling of the sound spreading. Sometimes two or more people start to improvise sounds together.

Group 45: Corridor of sound Ask the group to stand in two long lines, facing each other and quite close together. Everyone will start to intone a long aah, keeping the sound as supported and open as possible. People renew their breath whenever they need to, with the aim of keeping the group sound loud and continuous. The ‘top couple’ turn inwards and walk slowly down through the line of voices. As they move down they may actually feel the sound vibrations in a long corridor of sound. At the bottom they join the line again, and the next couple walk slowly down.

Group 46: Close duet (From natural voice practitioner Rosie Mor, personal communication, 2006.) Describe what you are going to do and ask for a volunteer to demonstrate this, before you ask people to try it in pairs. Stand face to face with the volunteer, quite close together, and ask him to intone a loud strong note. Heh and yee are the easiest sounds with which to work. He needs to stay on one pitch and keep the sound going, breathing when needed. You too start to intone that note, equally strongly, but then smoothly move your voice up and down around that pitch, moving just a few semi-tones so that you stay quite close to your partner’s pitch. This can produce some exciting harmonies and dissonances, and people can produce a powerful shared sound in their pairs.

Group 47: Vocal quartet or orchestra Put people into groups of four or five. One person is the conductor and stands facing the others. The others decide to be different musical instruments. They may hum, sing or make any non-verbal sounds they like on words, consonants, shrieks, groans, etc. However, the conductor controls the pitch, volume, speed and power of their voices by the use of his own hands and body as a guide. So, as he raises his hand their voices will get higher, as he makes large gestures they will get loud and as he makes small signals their voices will fade into quietness. They must watch him carefully and follow as precisely as they can. After a few minutes of sound exploration, someone else can try the job of conductor.

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Group 48: ‘Hello’ improvisation (From singer, composer and voice teacher Helen Chadwick.) Have the group stand in a circle, facing inwards; they may have their eyes open or closed, as they wish. Tell them that, when they are ready, anyone should call ‘hello’. The rest of the group come in with their own ‘hellos’ as and when they want, building into a group improvisation on this one word. This can also be done with simple humming. When one member of an on-going group had to leave the sessions to go travelling, we improvised a ‘good-bye’ version to mark her departure.

Group 49: Sounding an experience to another person In pairs, partners sit back to back on the floor. Leaning into each other, they make contact with the feel of each other’s backs, moving and rubbing against each other for a couple of minutes. You tell them that each person in turn is going to communicate a pleasant experience to his partner, using any sounds that she likes but no words. These can be short and varied, or longer such as a hum or vowel-based chant. The listening partner has his eyes closed and sees whether he ‘picks up’ any particular images, or whether it is just a pleasant ‘soundscape’. After a few minutes, ask them to change over, without talking about what happened. When both have had a turn, they can then discuss the experience.

Group 50: Finding your partner through sound In pairs, tell people that the focus of this exercise is on acute listening ability and the primacy of sound. Partners stands close to each other and decide on a little sound that will be their sound. It should be very simple and short, because it will be repeated many times. Examples might be a high-pitched ‘bee-bo’, voiceless ‘ch’, a tongue click or even a hum. The point is that this sound is unique to that pair. A closes her eyes and B starts to make the sound; B stays facing A at all times but slowly moves around the room, with A following the sound with her eyes closed. You will have given the instruction that all the eyes-open group members need to look after their eyes-closed partners, not letting them bump into walls or trip. You do, however, tell people that they may bump into other moving bodies; this should not hurt because they are moving so slowly. At any time the person with eyes closed has complete permission to open the eyes and stop the exercise. After a few minutes, clap your hands and let people see where they are and talk about the experience. Then change partners. You can then ask four couples to move into the middle of the room, while the others sit and watch. The A partners stand together facing outwards and close their eyes. The B partners move somewhere else in the room. At a signal from the leader, B partners make their sound and A partners have to move to find their partner, without opening their eyes. The leader needs to help guide the searchers and look after them, preventing them from

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bumping into another searcher, and gently moving them to face their sounding partner if they need help. For an enthusiastic group you can make this harder by suggesting that everyone make the same sound. Listeners then have to acutely ‘tune into’ the fine detail of their partners’ voices.

Songs Depending on your own ability, simple songs are a great way for people to use their voices in a group. There are many excellent workshops run by voice practitioners who specialise in collecting and teaching songs from around the world. As a non-musician I have a very small repertoire of songs for group work but do use simple rounds, because they are easy to teach and offer a chance for collective singing. Three Blind Mice and Frère Jacques work well as two parts singing together; just make sure that the group singing Three Blind Mice start a major third (two ‘steps’) above the starting note of Frère Jacques. If you do lead a group in simple songs, you are quite likely to find that people will often tell you afterwards how much they enjoyed singing, and that they have not sung for years.

Two sample group course programmes I include these two ‘real-life’ session plans to illustrate the way that a group workshop may develop.

A day voice workshop with a group of SLTs who want both to explore their own voices, and to expand their skills with clients For illustrative purposes I have expanded the description of the exercises far more than would be my ordinary practice. There are of course breaks and times for discussion and feedback. All ideas are explained in previous chapters or this one. 1. In a circle: name learning. 2. Stand and stretch. Throw a squidgy ball around circle saying your own name and another’s ‘Samantha–James, James–Helen’ and so on. 3. Physical warm-up – walk fast, stop when I clap, change direction and walk on. Get faster and faster, end with running. 4. Stop. Close eyes – observe heart rate and breathing. Let breathing slow down. 5. Explore movement and begin to connect to body; using music with Still–Stretch–Shake–Swing–Sway–Lengthen. Music – freer movement, dancing and stretching. In partners – copying each other’s movements, mirroring – still with music.

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6. Breath awareness work – stay in partners – hands on each other’s backs. Breathe and hum there. Breath work, with images of making the breath ‘do’ different things. Technical breath exercises – placing and control. 7. Channel release – face tapping, lip smacking, jaw release, tongue work, yawning and whispered haa, voiced haa, speech sound clarity and energy exercises. Silent scream into real scream; then mouthing instructions to partner across room through an imaginary glass screen. 8. Resonance awareness – explore each area in turn; resonating ladder and then using it in lines as ‘advancing troops’ exercise (one line of people making the sound as they move in on the others, who sit on the floor under the advancing ‘wall’ of sound). 9. Pitch extension – sirens and scales and speaking up the range. Conducting the group in different pitches on counting, with first me and then others as leader. 10. ‘Big’ voice – exploring resonance and then projection. 11. Articulation games – speech sounds, text exploration in partners and then – for anyone who wants – speaking the text to the group. 12. Freeing and enjoying the voice in a range of games and improvisations: (a) Internal and quiet, on floor – humming into different parts of the body; find a sound that expresses how you feel; group humming improvisation. (b) External and standing and then moving with vocal energy – finding partner by sound alone; calling hello, hello improvisation with eyes shut; strong open voice in calls around circle. 13. End with group singing – half sing Three Blind Mice at same time as other half sing Frère Jacques. Move with the song around room. 14. In circle, three group breaths and a long intoned aah to close.

An example of a 2-hour workshop on a ‘team-building day’ for 11 members of a newly established arts-based company Themes – energy, extension, listening, partnership, imagination: 1. Acknowledgment of each other in the group: in a circle, throw a ball with eye contact and saying name. Then no ball but same eye contact and sending energy to each other. 2. Movement sequence: to music – stretch, walk around room, smile at each other with eyes only, greet every person individually with sound alone, then repeat with ‘hello’ only. 3. Muscular voice work: Breath placing. Open throat – yawn. Open jaw – jaw test. Resonating ladder. Pitch games. Centre sound – martial arts strong Ho! Hah! Hey! Long sounds – extend into distance from centre of room. 4. Listening: sit in circle – roll ball/orange to each other as make a sound – listen to that person’s sound and reflect the sound back as exactly as possible.

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Circle sitting – back to back – whole group counts 1 to 11, one number each, trying to sense a moment when each can speak a number. If two speak at the same time, stop, and go back to the start at number 1. 5. Partnership work: mirroring movement. Conversation in gibberish about something that had happened – then discuss if people have any idea what their partners were trying to communicate. Finding partner by sound alone. 6. Listening and making sounds – work calls for energy. 7. End – sound baths on long vowels and singing a round.

Part 6

Voice disturbance

The word ‘disturbed’ is used when something has its normal pattern or function disrupted. It is an apt word for voice impairment or limitation, because it also suggests the emotional effects that such vocal problems may have on a speaker or singer. This part looks at four aspects of voice disturbance. Each chapter introduces core aspects to those who are relatively unfamiliar with the topic, and also offers a range of specific ideas and case stories for those more experienced in each field. Chapter 27 provides a basic introduction to the main voice disorders for non-clinically trained voice practitioners, and speech and language therapists moving into the field. Voice disorder is a huge and specialised area, and the recommended texts are comprehensive in their detail of disorders and their treatment. Chapter 28 examines the demands on those who use their voice as part of their daily work and introduces a new classification of professional voice users into six groups. Practical work ideas are suggested for each group. Chapters 29 and 30 describe the special demands placed on the voice of the actor and singer, and how vocal disturbance may affect them. They describe aspects of the training and work demands for those practitioners less familiar with these professions. Suggestions are made about how performers’ voices can best be protected and supported.

Voice Work: Art and Science in Changing Voices. Christina Shewell © 2009 Christina Shewell. ISBN: 978-0-470-01992-4

Chapter 27

The disordered voice

What is a voice disorder? The term ‘voice disorder’ is used in the clinical world to describe a voice problem with suspected cause of a possible physical abnormality in the structure or function of the vocal tract. ‘Dysphonia’ refers to disordered phonation, and ‘aphonia’ is generally used for the whispered voice that has no vocal fold closure. Similar to singing and spoken voice teaching, the treatment of voice disorders is a highly specialised activity and should always be carried out by a speech and language therapist/ pathologist. Structural and functional laryngeal problems are the most common cause of voice disorders, but other communication disorders can create problems in the sound of a voice. These include dysarthria, a disturbance of speech muscle control caused by damage to the nerves or the brain which may occur as a result of stroke, accident or progressive disease; Pam Enderby (in Palmer 2007) estimates that 250 people in every 100 000 have dysarthria Even if a client has severe dysarthric speech sound limitations, work on other aspects of voice may improve his overall intelligibility, and this may be true for the voice of clients with hearing impairment, learning disability or stammering. In 1980 the World Health Organization introduced and defined three terms: impairment, disability and handicap. These can be applied to voice disorder, and may help a voice practitioner to distinguish between a voice disorder and a general voice problem. • Impairment = abnormal function, as in a voice disorder when there might be excessive breathiness or pain when speaking. • Disability = a change in behaviour or performance, as when a speaker finds that he cannot talk without voice strain. • Handicap = disadvantage in relation to others, as when a speaker or singer finds that her career is limited because of her disturbed voice quality. Estimates of the exact numbers of voice disorders vary widely. They occur more often in women than in men, but, in children, boys outnumber girls. Only a small proportion of clients referred to a general ear, nose and throat clinic will have dysphonia; this is probably one reason why there are relatively few ENT consultants who specialise in voice (as opposed

Voice Work: Art and Science in Changing Voices. Christina Shewell © 2009 Christina Shewell. ISBN: 978-0-470-01992-4

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to ears and noses). The largest dysphonia group is the one in which the voice difficulties are caused by too much or inappropriate muscle tension. Many of these will have normal looking vocal folds, but for others the misuse may cause changes in vocal fold structure, such as swelling, inflammation, nodules and polyps. From clinical experience and colleagues’ opinions I would estimate the misuse group to be as high as 60–70%, and this is supported by the literature. For some, psychological stresses emerge as major contributors to the muscle use issues, whereas for others the main cause is the practical demands placed on their voices, e.g. two musical theatre singers may be diagnosed as having slightly swollen vocal folds and a dysphonia caused by significantly excess muscle tension. One may be in a 3-month rest period between shows, with considerable stress and relationship problems, whereas the other may be a cheerful performer with little training in technique who has strained her voice after a heavy cold. Although a significantly disordered voice usually has a noticeably disturbed quality, milder voice disorders may seem like the temporary voice strain often encountered by voice or singing teachers. Symptoms can come and go; a lecturer may sound normal on a Monday, but report that his voice is poor by Friday. A singer may unpredictably have problems in pitch control, but these occurrences ruin her confidence and career. No voice practitioner can ever reliably identify the nature of the voice disorder by the sound of the voice. The sound of a voice may give clues about vocal tract and fold function, but it cannot specify the pathology that is creating that sound. High-level laryngeal examination is essential, and there are frequently surprises. Misdiagnoses by voice practitioners can be both dangerous and upsetting to clients.

Voice story: Jane Jane was a 15-year-old schoolgirl with a good singing voice. After a busy summer of festival singing, working in a shop and a hectic social life, she started lessons with a new singing teacher and noticed that her voice was sometimes a bit strained. She worked hard to ‘push’ the voice as high as possible but found that she could not reach her upper range. Her teacher became anxious and told an older colleague about Jane’s problem. Although this second singing teacher never heard the young singer’s voice, she was adamant that Jane had nodules and should stop singing immediately. The younger teacher told Jane of her conclusions and banned her from any choir or individual singing. Jane had heard that nodules ended singers’ careers and was very upset. Her mother rang me for advice, and of course I said that Jane should see an ENT specialist as soon as possible. I stressed that a reduction in pitch range was certainly no firm diagnosis of nodules. Endoscopy found no abnormality on Jane’s vocal folds, simply the suggestion that at high pitches she over-tightened the laryngeal muscles.

Referral for a voice disorder If you are working as a voice or singing teacher with a client who describes an unexplained hoarseness of longer than 2 weeks or voice problems that happen on a regular basis, the rule is always to refer for a medical check-up. A typical process is that a client with a voice

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problem goes to see his local doctor. She will take a full history and examine the person, and may then suggest rest or antibiotics. If there is no improvement over 2 or 3 weeks, she should refer the client to an ENT specialist at a local clinic. (Chapter 3 describes details of the likely examination procedures.) The specialist will suggest any medical management needed, such as drugs or surgery. If none is required, or if muscle misuse or psychological stress is contributing to the disorder, the client – adult or child – may then be referred for voice therapy. SLT departments vary in the length of their waiting lists. Usually voice therapy is one to one, but may be supplemented by group work, where the sharing of ideas and experiences can be valuable.

The voice disorders A traditional classification of voice disorders is into two main groups: 1. Organic: something is structurally or systemically wrong in the body to cause the voice disorder, e.g. an unrepaired cleft palate, a cyst in the vocal fold, damage to an important laryngeal nerve or a neurological problem such as Parkinson’s disease. 2. Functional: the main cause is a problem of ‘malfunction’, e.g. an occasional hoarse voice and throat discomfort in an amateur actor, a sudden voice loss in an emotionally distressed woman or an abnormally high voice in an adolescent boy whose body had matured normally. There has long been considerable discussion and dispute in the literature, because this classification is not clear cut. There are several voice disorders where a structural problem is seen on the vocal folds, caused by a particular use of the voice. In many organic problems, the sound of the voice is made worse by a secondary pattern of over-tense phonation patterns. Reducing strain can help traumatised vocal folds to recover en route to improved voice. The causes of many voice disorders are multi-factorial, and a large part of the therapist’s task is the detective work needed to unravel the different contributions. The treatment of voice disorders has multiple strands, but there are three core voice therapy aims: 1. To protect the vocal folds and laryngeal mucous membranes from further damage 2. To help the person to produce the best voice possible by reducing unhelpful habits and incorporating positive vocal techniques. 3. To emotionally and practically support him in dealing with the effects of the voice disorder on his life. The list of voice disorders in this chapter are classified into three main groups: 1. Functional: primarily muscle tension origin. 2. Functional: primarily psychogenic origin. 3. Predominantly organic origin.

Group 1: functional – primarily muscle tension origin The use of the voice affects the way that it works and the way that it sounds.

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Muscle tension dysphonia (MTD or muscle misuse dysphonia) This voice disturbance is caused by excessive tension or inappropriate use in the relevant voice muscles. These will usually be those of the channel and larynx but often involve other generalised muscles. MTD can be seen as a long-term version of the temporary voice strain or misuse that most practitioners encounter at some time. The vocal fold structure will look normal, but various sorts of constriction may be seen in the larynx and vocal folds as the person speaks or sings. ENT specialists differ in their ability and motivation to notice or describe these details of function. Typical MTD symptoms include all or any of those listed below. These may also occur in an organic voice problem, because all occur when someone uses extra tension to ‘push’ out his voice. That is why laryngeal examination is always essential. 1. Discomfort in the throat or around the larynx. 2. Excessive roughness, breathiness, creak or laryngeal strain when talking or singing. This may be continually present, or become progressively worse if the person voices for long periods or over noise. 3. A lack of ‘power’. 4. Impaired pitch: excess tension in the extrinsic laryngeal muscles can lead to a change in habitual larynx position, which may affect pitch and quality. If the vocal folds are slightly swollen, the pitch may sound lower. 5. A lack of stamina: the speaker tells you that she regularly feels a sense of strain or impaired sound if she talks for long periods. 6. A feeling of a lump in the throat: the medical term for this is ‘globus’. This can occur when a client has reflux, but it may also occur with specific excess tightening of the throat muscle fibres. Although the doctor may reassure a client that there is no lump, she may continue to feel the sensation and even fear that it is a hidden cancer. I sometimes explain it as a kind of ‘bunching’ of the muscles, as when shoulder muscle fibres can be felt as tightly ‘knotted’. Figure 27.1 shows how the vocal folds are hidden, as the front and back of the laryngeal area ‘squeeze inwards’ – a clear illustration of the physical reality of laryngeal constriction in MTD.

Temporary vocal fold swelling (oedema) If we have laryngitis or a heavy cold and cough, our vocal folds may be inflamed and swollen. If they are used with excessive tension or irritated by excessive alcohol, cigarette smoke or other fumes, the body’s physiology may send more fluid into the second layer of the vocal fold structure. This extra fluid gives a kind of ‘padded protection’ to the layers below, and plays a role in trying to heal the inflammation. The swelling may be ‘temporary oedema’, which can occur as an occasional result of energetic voice use. People who sing hard at a carol concert, or talk over loud background music, may later find that their voices sound deeper and rougher, because their vocal folds are slightly thicker with reactive swelling. It usually subsides with vocal rest. If hard voice use is habitual, there may be a longterm oedema and erythema (redness) as the blood supply increases to bring the ‘mending’ blood cells to the area.

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Figure 27.1 Laryngeal constriction. (Reproduced with permission of Mr Tom Harris.)

Reinke’s oedema (also called polypoidal degeneration or polypoidal corditis) Reinke’s oedema is a chronic condition of excess fluid in the second layer of the vocal folds, Reinke’s space. It usually occurs in older people whose vocal folds have experienced longterm irritation from smoking, alcohol or toxic chemicals. As the folds are thickened, the voice is rough and low in pitch, and the deep pitch of an older woman may sound like that of a man. Reflux, with its regular bathing of the vocal folds in gastric acid, can also contribute to this vocal fold reaction. Although Reinke’s oedema is not a healthy condition for vocal folds, it does not present a danger to life; indeed laryngeal cancer almost never occurs in people who have true Reinke’s oedema (Martin Birchall, personal communication, 2007). Voice therapy can ensure healthy voice use but cannot restore the normal thickness and flexibility of the folds, although surgery can aspirate (suck out) the excess fluid if necessary.

Voice story: Reinke’s oedema with MTD and relevant environmental factors Tony was referred with a 2-year history of hoarseness, sore throat and globus. Examination found moderate Reinke’s oedema; the ENT specialist did not advise surgery. Tony worked in a zinc works with levels of toxic fumes so high that every 3 months his section

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workers had blood tests to check their lead levels. He described a ‘permanent collection of mucus in my throat’. Anti-reflux medication did not help. Tony hated the air quality and said ‘I often feel I’m holding my breath at work’. Although there was a strong likelihood that his working environment was contributing to his problems, not all workers there had his symptoms, and he had several MTD patterns. I advised him to increase his hydration levels and use steam inhalation when he got home each day after his shift. We worked practically to reduce his excess laryngeal constriction and improve breath support. After three sessions, his globus had virtually gone, his throat was less sore and his voice quality improved.

Nodules/Nodes Nodules (Figure 27.2) develop as a result of long-term patterns of MTD. They are small benign growths from the covering of the vocal folds and do not turn into cancer. They can be likened to small calluses that develop to protect the underlying tissues if a speaker’s habitual voice use has a pattern of too tense vocal fold closure. Nodules nearly always occur on both folds, at the place where the vocal folds close together at their hardest – the junction of the front third and the back two-thirds of the vocal folds. At first they will be pink and soft, so that the folds may still be able to close. In those early cases, a first symptom may be a lack of high pitch control, because the folds can no longer stretch so competently. If voice misuse continues, the swellings become white and more solid in appearance, and may be referred to as hard nodules. Any lump or swelling of the folds increases its thickness (or ‘mass’), so the general pitch of the voice is usually deeper. As there is a specific lump, smooth vocal fold vibration and closure are affected so there is roughness and breathiness in the vocal quality. This often gets worse after a heavy night out when there is additional vocal oedema. Mathieson (2001) reports that nodules are the most common vocal fold damage caused by hyperfunction. They occur more often in young boys than young girls, but are most commonly found in young to middle-aged women. Abitbol (2006) states firmly that ‘most women in South America have vocal nodules’, but this wide generalisation has yet to be proven by research. Some writers have suggested that nodules are more likely to occur in people with certain personality traits such as perfectionism, unwillingness to delegate and excessive sociability – along with a general habit of speaking loudly. There is little credence for definitive generalisations, but ‘nodules rarely occur in shrinking violets’ (ENT surgeon Garfield Davies, personal communication, 1998). Many people with nodules are ‘loud in a crowd’, with lively, talkative personalities, but there are usually other contributing factors such as a general tendency to throat and nose problems, a new vocal demand or a long period of extra emotional stress. A detailed description of a collaborative approach to treating nodules in an actor is included at the end of Chapter 29. Box 27.1 refers to a child who was referred with this diagnosis.

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Figure 27.2 Soft nodules. (Reproduced with permission of Mr Tom Harris.)

Voice story: Jamie Jamie was referred to me with small ‘soft’ nodules, having had several months of problems with his singing voice. He was the elder of two children and a tall 11 year old. He had no signs of puberty body or vocal change. There was considerable pressure on Jamie as a singer; he had recently transferred to a large cathedral school, with a choral scholarship. He was generally a bright student and a high achiever, who had already been a successful semi-professional performer, but he told me that he was ‘a bit of a worrier’. Jamie’s nodules had developed through vocal misuse, but it seemed likely that that there was possible contribution from his own physical/emotional stress levels. Jamie’s singing voice quality was reduced in stamina, range and quality. His spoken voice was usually normal, although it was quite rough and breathy on the day that I saw him, after a football match the day before. Box 27.1 shows Jamie’s full Vocal Skills Perceptual Profile (VSPP); you will see that his total score was 20. This is not a high score, but the parameters showed significant areas for work. Jamie had six sessions of voice therapy, spread out over 3 months. Each meeting lasted 45 minutes, and included work on body-tension release and specific voice work, some of which involved a computer software program. He practised on his own and with his parents between meetings. Although he had to miss out on Christmas singing commitments, there was a slow but definite improvement in Jamie’s voice and it was back to normal singing power and quality by the following February, 3 months after his first voice appointment. ENT check-up found that the nodules had gone.

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Box 27.1 Jamie: Voice Skills framework Jamie (aged 11, with vocal nodules) Total full VSPP score = 20 Speaker’s own words about his or her voice ‘Sometimes my voice cuts out a bit, it can get husky – but mostly it’s working perfectly fine, quite normal. It’s about 90% normal function in speaking – less in singing. I have to sing for my supper, because I’ve got a scholarship to my new school to sing in the choir.’ 1 Body: posture, movement, muscle tension, vocal tract sensation, health and body Slightly slumped today – father says typical of ‘pre-teenager’. Shoulders slightly tight, significant excess tension in sternocleidomastoid and extrinsic laryngeal muscles. No reports of discomfort but Jamie says he sometimes feels ‘slight grating in my neck’ when he talks. He says this term he has been having trouble sleeping ‘I get in a mental state of positive tension and then I have difficulty turning my brain off’. Health good –fit as plays regular sports at school, in local under-13 football team after school time. 2 Breath: placing and control Lower breath pattern – Jamie is aware of breath for strong voice as had extensive acting/ singing experience and teaching when younger. Sustained sss = 15 seconds. Sustained zzz = 10 seconds (surprising not better, given that J has done much breath control work in singing lessons). Occasional audible ‘gripping’ towards the end of long sentences. I got J to speak the sentences after me and he had difficulty sustaining his breath support towards end of longer ones. 3 Channel: face, lips, jaw, tongue, soft palate, pharyngeal, laryngeal Wide range of lip movement, with habitual spread setting. Open jaw setting, and wide range of movement. Appropriate range of tongue movement. Habitual fronted setting. Soft palate fine, no pharyngeal constriction. Definite audible laryngeal constriction – a kind of an ‘edge’ in his spoken voice. Jamie did several audible glottal closures in silent thinking. Father says this is a habit. 4 Phonation: rough, breathy, creak qualities, phonatory stamina and other features Roughness in phonation quality. Slight excess breathy quality. Definite creak. Jamie says ‘it can get a bit tired’ and his father later told me that after a ‘big sing’, he often has a rather strained and breathy quality in his voice until the next morning. Breathy vowel onsets and occasional ‘silent’ glottal stops. 5 Resonance: features of head, oral and chest resonant quality and focus of oral placing Good balanced resonance – a strong ‘chest’ resonant impression – possibly developed during Jamie’s long history of practical voice work. Marked fronted oral resonance tone in speech. Jamie gets ‘lots of tickle’ when he hums.

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6 Pitch: centre, range and intonation patterns/variety Normal for age – no signs yet of voice breaking yet, says father. Glide reduced at top of pitch range – noticeably breathy and strained. Wide range in speaking and reading 7 Loudness: overall loudness level, variety and control, and use in emphasis Impression of a ‘big’ voice, partly to do with his volume level, and partly his fronted oral placing and strong chest resonance, which gives an impression of strong projection. Father says J very loud at school, and with friends at home, little variation and ‘high dramatic use!’ Lots of loudly stressed words. Audible and visible tightening around the larynx as J gets louder or higher in pitch. 8 Articulation: consonant and vowel clarity, pace, pause, fluency, rhythm All fine. Other Jamie is the older of two boys, with settled and happy home life. He has been a successful performer for several years and has been a real ‘star’, with roles in both local shows and a television ‘soap’. He is a highly intelligent boy who recently transferred from a small school to a much larger and more demanding secondary environment. He is having problems getting off to sleep most nights, and both father and he describe him as currently finding school life quite stressful.

Note on voice therapy with children The principles of healthy voice use are universal, but of course the techniques used must be adapted to the age and culture of the client. With very young children, work is generally done through the parents or carer, and always in the spirit of play; as an older child singer, Jamie was well used to direct work but naturally all activities were kept as ‘fun’ and selfmotivating as possible.

Polyps Polyps develop from the Reinke’s space layer of the vocal folds, but, unlike general swelling, they are very distinct protrusions (Figure 27.3). They vary in shape and size, and in their effect on the voice. It is possible to have a large polyp that can vibrate and a small nodule that cannot; voice quality would be worse with the second. Nodules used to be seen as arising from long-term misuse, with polyps appearing quickly from strong periods of vocal abuse. So, if a young girl screamed loudly for a couple of hours at a rock concert, she would not develop overnight nodules but might wake with a vocal fold polyp. Nowadays it is generally agreed that polyps can take time to form and, like other forms of laryngeal damage, they may be associated with reflux. If this is resolved, the polyps or polypoid appearance may shrink, but most polyps need to be surgically removed.

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Figure 27.3 Polyp and swollen vocal folds. (Reproduced with permission of Professor Martin Birchall.)

This image shows a large polyp and very swollen vocal folds. (The plastic object between the folds in this and other images is the breathing tube needed during the surgery when the photographs were taken.)

Vocal fold haemorrhage A haemorrhage is an escape of blood from a ruptured blood vessel. On the vocal fold it may just be one tiny blood vessel or involve a large area, and its effect on the voice depends on its size and position on the fold. Haemorrhages sometimes occur as a result of intensive coughing or crying. Sataloff (1997) says that aspirin and the premenstrual period make them more likely in women singers who sing hard and strongly. The voice suddenly becomes hoarse with unreliable pitch control; one young male singer described it as a feeling ‘as if a rubber band had snapped in my cords’. The word ‘haemorrhage’ can sound very frightening but usually the rupture is small and may be like a broken vein on the cheek. With well-planned and strictly adhered-to rest, the bleeding is usually reabsorbed and disappears. It is essential that singers or actors stop strenuous singing or voicing until there is at least some healing, or further bleeding may result. This needs to be checked by keeping in close touch with the ENT specialist. If there is a bleed into a polyp, the speaker may be told that he has a ‘haemorrhagic polyp’, and surgery will be needed to remove the polyp.

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Contact ulcers and granulomas Colton and Casper (1996) say that there is wide evidence that reflux is a major cause for both these vocal fold pathologies, but excessive throat clearing and coughing, and abusive voice habits, can also be a major contributor. Both can cause significant voice problems and discomfort when they occur. Voices are rough, creaky and strained, and clients sometimes complain of a pain that connects the larynx area to the ear. Contact ulcers occur at the back of the vocal folds, and may be associated with a habitual pattern of low-pitched, creaky, tight voicing in which the arytenoid cartilages vibrate very forcefully. They are virtually confined to men, and the traditional example given has been that of the loud ‘macho-voiced’ American salesman. Although not common in the British voice clinic, Mathieson says that, in the past four decades, she has seen an increasing number of British men with contact ulcers who have needed voice therapy (personal communication, 2007). Granulomas may occur with contact ulcers and Sataloff (1997) refers to ‘contact granulomas and vocal process ulcers’. They can occur after strenuous long coughing or develop with vocal fold damage caused by a breathing tube during an operation. Management is usually a mixture of medication and strategies for reflux treatment, together with general voice care and techniques. Surgery may be carried out but there is always the risk of recurrence.

Group 2: functional – primarily psychogenic origin As we saw in Chapter 15, emotions can have a direct effect on voices as a result of changes in the autonomic nervous system. Butcher et al (2007) describe how an internal emotional conflict may be somatised (transferred into a bodily symptom) at the site of least physical resistance, e.g. a person’s emotional conflict and corresponding bodily tension are likely to worsen any long-term symptoms that she may have – whether these are migraine, irritable bowel syndrome, eczema, asthma, throat problems or other ailments. Some ‘body-based’ psychotherapists say that the nature of the stress will target particular points in the body, to express itself symbolically. So a client who does not want sexual contact might develop gynaecological or urinary problems, a client in conflict might feel regular nausea as he is metaphorically unable to swallow the situation, whereas a woman over-burdened by responsibilities might develop a back problem, as if she could carry no more. Although there are often emotional components in clients of group 1 (functional, mainly muscle tension), in psychogenic dysphonia, emotional stress is considered to be the main contributing factor. It may cause a person to develop a tight strained sound, a high pitch, a vocal tremor, weak whisper or other vocal symptom. ENT examination usually shows that the folds can work normally in coughing or throat clearing, but they do not do so in speaking. Sometimes laryngoscopy shows that the false vocal folds are being used to phonate instead of the true folds. The client is not deliberately ‘putting on’ any of these voices; it is an unconscious emotional stress reaction in the relevant muscles. Psychogenic disorders are more common in women than men, and usually not associated with a serious psychological disturbance, such as psychosis or schizophrenia. There is

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continued discussion and dissent around the term ‘psychogenic’ and Baker et al (2007) and Butcher et al (2007) provide detailed considerations. Baker et al say that patterns of muscle tension ‘are secondary to the psychological processes operating’, whereas Butcher et al take the view that psychogenic dysphonia occurs when the cause is ‘largely of psychological or emotional conflict’ and a ‘primary organic process has been eliminated’ (my italics). This allows them to consider that excess musculoskeletal tension resulting from significant psychological issues may eventually cause a laryngeal pathology, so that even a speaker with nodules can be thought of as having a psychogenic dysphonia.

Voice story: Ann Ann was a quietly spoken divorced woman in her late 50 s who worked part-time as a secretary for a small firm. Her referral described ‘small soft nodules’. Her voice was mildly rough and whispery, and she had noticeable laryngeal constriction, describing a frequent feeling of tightness and pain around her laryngeal area. She rarely raised her voice and said that she needed to speak little in her job and had no ‘voice heavy’ hobby, so there did not seem a clear reason for the development of nodules. However, during the second session it emerged that Ann had considerable emotional stress in her life. Her daughter was having a trial separation from her husband in Australia, and had been staying with Ann for several months with her 2-year-old son. She needed a lot emotional support and, as her little son woke up several times each night, Ann’s own sleep was very disturbed. In our session she was able to talk at length about her mixed feelings of love, anxiety, anger and guilt, and her sense of isolation that she had not been able to share her feelings with anyone. She followed every practical suggestion for body and voice care work. Nodules do not disappear quickly but by the end of three sessions her voice quality was clearer because her general body and laryngeal constriction was better. Three months after her diagnosis, the ENT check-up found that her nodules had gone.

Psychogenic voice disorder is a complex area. Sataloff (1997) defines it as ‘caused by psychological rather than physical dysfunction’, but there is a physical dysfunction, which may indeed continue after the initial emotional issues have diminished or been resolved. The triggers may be predominantly emotional but the behavioural dysfunction is physical; a woman’s voice may disappear on the day that she hears her brother has been killed, but her frail whisper is created by disturbed larynx position and vocal fold closure.

Hypothetical voice example When thinking about a new client where emotional tension may be contributing to the voice disorder, I sometimes use a simple image of what might be the percentage of structural or misuse contributions as opposed to possible emotional issues.

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Example 27.1 A 45-year-old woman is referred with muscle tension dysphonia, and a rough, breathy and strained voice. She is happily married, with what she describes as a contented personal and working life, and rates herself as 3 on an imaginary 1–10 stress scale, though she does say that she is ‘permanently exhausted’. She is a busy telephonist and has mild asthma, poor posture and a lack of voice training; her throat often feels strained and sore and she is anxious that she may have to take time off work. This client’s voice problem might be considered as 80% usage and 20% emotional contributions.

Example 27.2 Another 45-year-old telephonist is referred with muscle tension dysphonia. She rates herself as 9 on the stress scale and is dealing with significant exhaustion in caring for her elderly mother and distress about her disintegrating marriage. She had 2 hours of voice training, and feels that in the past this helped her deal with her work demands. Now, however, she finds that her voice is regularly rough, breathy and strained. This client’s voice problem might be considered as 30% use and 70% emotional stress contributions.

Clearly these figures are just impressionistic but they can help a practitioner think about an appropriate balance of practical and counselling type work with a particular client. The first aim is often to improve the voice so that the person can then more easily talk about life and feelings. Baker (2003) describes cases whose voice loss is linked to some forgotten traumatic event that has focused on the throat or breathing apparatus, and threatened life in some way. These speakers are concerned about their voices, and highly motivated to improve, but symptomatic voice therapy alone cannot solve the problem. Although rare, these cases of ‘trauma conversion’ do clearly demonstrate the mysterious link of memory, feeling and voice.

Voice story: psychogenic trauma dysphonia John was a 35-year-old electrical engineer whose rough and strained voice appeared to be caused by muscle tension dysphonia. ENT examination showed normal laryngeal structure, but a visible pattern of laryngeal constriction. John’s shoulder, neck and extrinsic laryngeal muscles were all very tight and his voice was audibly strained. He could release this in exercises such as the yawn–sigh, but then reverted to the tenser pattern. John walked with a slight limp, and told me that he had fallen overboard from a speedboat when he was 4; the propeller had almost severed one foot, and since then he

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had problems with his leg and hip. I wondered if there were postural issues in his voice problems. At our third session, after we had been doing some semi-supine floor work, he rolled over onto his stomach en route to getting up, and stretched his arms above his head, pushing his face into the carpeted floor. He stayed there for a few seconds, unmoving but appearing to gasp for air. After a few moments he said ‘it’s like when I was trying to turn over in the sea, and I swallowed all that water and I couldn’t breathe’. As we talked about it, he expressed considerable distress and shock that he could have forgotten about this struggle, and said that, to his conscious knowledge, he had never thought about it since; the focus of concern had always been on his leg. The body movement had accessed a deep memory that was highly relevant to his voice therapy process. When he returned for the fourth session, his dysphonic symptoms had greatly improved, and we both felt that this was not simply as a result of generally improved voice skills.

Clients with psychogenic dysphonia often seek reassurance that they are not deliberately creating their voice symptoms, or that it is ‘all in the mind’. When working with someone whose voice problem is clearly closely linked to an emotional state, we may say something like ‘it’s never all in the mind, because it’s clearly in the muscles, but the mind can make muscles over-tighten and that’s why we attend to both in voice work’. This kind of explanation can be helpful for any client who recognises that his voice difficulty is worse when under emotional stress. The voice therapy story of a child with psychogenic dysphonia is described at the end of this chapter.

Puberphonia (also called delayed pubertal voice change or mutational falsetto) As a boy’s body changes at puberty, his larynx enlarges and his vocal folds lengthen, with his voice usually dropping in pitch by an octave. A girl’s voice also deepens, though not to the same extent as a boy’s. If these changes do not happen, it may be for one of three reasons: 1. A hormonal imbalance, affecting both voice and other secondary sexual features. An endocrinologist will be involved in treatment, because this is not a voice problem of psychogenic origin. 2. A small web of mucous membrane across the front of the vocal folds can restrict their ability to release into deeper pitches. Some people are born with this but it is detected only at puberty. 3. The adolescent physically matures normally, but the voice stays at or near the previous youthful high pitch. Suggested ‘psychological’ causes have included a fear of growing up into adult sexuality or responsibilities, but there are many cases of puberphonia that seem better classified with the muscle misuse disorders. Examples include the talented treble choirboy who unwittingly prolongs both his spoken and sung high voice by excess tension settings, or the young man who tries to control embarrassing voice breaks by an over-high laryngeal position.

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In this last group, the larynx will be normal in structure and size, but is likely to be held in an unusually high position by tight laryngeal muscles, and the thyroid cartilage is often tilted forward, stretching and thinning the vocal folds. Techniques to lower the larynx and deconstrict the pharyngeal/laryngeal area are often effective, generally accompanied by calm, almost ‘hypnotic’ instructions and reassurance. Most young men are immediately able to connect to a deeper older male pitch, but this may be a shock and take time to incorporate. Once the voice is found, the speaker can be gently encouraged to talk about why the delay might have happened. In some cases a reason becomes clear – in others, it never does. If a voice does not drop after good voice therapy and the client is willing, he can be referred to a counsellor or psychotherapist. Puberphonia is much more common in boys than girls. Although a somewhat high pitch may be a feature of a generally over-tight voice in a shy or self-conscious woman, it is different to the true child-like voice of puberphonia, which is very rare in women.

Voice story: Beatrice Beatrice was an actor. She was a small young woman, who told me she was 19, though I knew from her birth date that she was 28. The ENT report said that she had a normal looking larynx, but her voice was noticeably high and childlike, with an average centre pitch of around 392 Hz, around G4 on the piano. (Reminder – the average female pitch is around 220 Hz.) She had long played roles as young naïve girls, but now felt that her high voice would limit her chances of being cast in the young woman roles that she now hoped to play. Beatrice had lived with her parents for the last 2 years, but talked anxiously about the need to move into her own home. She said that she found being with her father very difficult, but did not want to talk about the nature of that relationship. She hinted at some sort of abuse, but it never became clear whether this was emotional, physical or sexual. As we worked together Beatrice was pleased that she could produce a noticeably deeper resonance in her spoken voice. She could also manage a slightly lower pitch in exercises (e.g. letting sound be released as she jumped up and down, groaning and producing a gentle mmm with a vowel sound), but there was no carry-over into her ordinary voice. Although she said that she wanted a deeper-pitched voice, I sensed a resistance to actually changing. As the sessions progressed she began to say that she really just wanted a ‘stronger, slightly less light’ voice so that she could play young women. By the end of the six sessions, we agreed that therapy had gone as far as possible. She liked her increased vocal power and chest-resonant quality, but I had not been successful in deepening her pitch. I had come to believe that, at a deep level, Beatrice did not yet want to ‘grow up’ – in voice or life. I made some links for her between feelings and voice, but my skills were not deep enough to confront her about the core issues. I encouraged her to talk to a professional therapist about some of her anxieties, with the expectation that this might then connect to her feelings about youth and ageing. She said that she would consider seeing a counsellor; I am doubtful that she did.

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Transgender/Transsexual voice Although these clients are usually listed under the psychogenic heading, they are quite different to the other functional voice disorders. In this group, voice work aims to train the spoken voice of a person of one gender to sound like that of the opposite. It is often carried out in a clinical setting, but a good voice teacher with the appropriate knowledge can also work well with these clients. (Voice teachers worked with the voices of Dustin Hoffman on the film Tootsie and of Felicity Huffman in Trans America.) Whichever voice practitioner does the work, it is important that vocal fold strain be avoided because muscle tension voice problems can result if the client constricts in her attempts to reach higher pitches. Transsexual clients feel intensely and deeply that they are living in a body that is the wrong gender for ‘who they really are’, and usually this sense goes back to childhood or early adolescence. Jan Morris’s book Conundrum (1974) remains one of the best introductions to the journey of change from one gender to another. It is a long and challenging process; once the person has acknowledged and accepted the feelings, and made the decision, there are personal relationships to manage, and social and vocal skills to be learnt. The client must generally live as a member of the opposite sex for 2 years before reassignment surgery. Most voice work in the transgender field is with male to female clients, and success varies in achieving the goal of an acceptable feminine voice. Laryngeal and resonator anatomy, motivation, willingness to practise, general body size, shape and image and other factors are all relevant. Work should include all the eight Voice Skills areas, because pitch is not the only relevant factor, and many clients are unable to achieve a pitch that is high enough to pass as female in all situations. As described in Chapter 12, a centre pitch of <155–160 Hz is judged to be male by listeners. In direct work on pitch the use of computer visual analysis and display is invaluable, but, if not available, a simple keyboard can still be a good aid. Direct surgery to shorten or stretch the vocal folds may be considered, although this does not have a high client satisfaction success. If a woman wants to become a man, the use of male hormones will permanently deepen the pitch of the voice, because the vocal folds become thicker. Although coaching in other male-style communication skills may be necessary, voice therapy work on pitch is unlikely to be needed. Sometimes younger women are treated for serious conditions with synthetic male hormones; the voice usually deepens and women are not always warned of this.

Voice story: Marisa Marisa was a singer who came to see me after testosterone implants for breast cancer treatment had lowered her voice pitch. She had not been told that this might happen and was devastated by the deterioration. It was not possible to raise her average pitch, but, after a thorough sequence of physical release and sirens, swoops, glides and arpeggios in the first session, we realised that she had more variation than she had thought possible within her narrowed range. Her emotional distress about her changed voice had led to various patterns of general body tension and vocal constriction that had cramped her flexibility, and created a roughness in her vocal note that could be changed. Voice therapy reestablished healthier voice use, but she also needed to develop a new way of singing with her new voice, and I referred her to a singing teacher with special experience of remediation. This singer had to change her repertoire, but she was able to go on performing.

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Group 3: predominantly organic origin Only the more common problems are included in this section. None is treated by voice therapy alone, although this may supplement medication, surgery or other management.

Laryngitis A heavy cold and cough may or may not lead to short-term laryngitis – an inflammation of the larynx. In Webster’s (1996) The White Devil, Flamineo says ‘I have caught an everlasting cold; I have lost my voice quite irrevocably’. Colds rarely lead to permanent voice loss, but chronic laryngitis can cause irreversible voice problems. This usually develops over a long period of time and throat irritants such as long-term smoking, alcohol intake or environmental fumes are often relevant. There is long-term damage to the vocal folds, which will probably appear thick, dry, rough and inflamed, with thick sticky mucus. Regular ENT monitoring is suggested because occasionally more serious vocal fold conditions can develop.

Voice Story: Professor B Professor B was a 63-year-old historian, who had been diagnosed with chronic laryngitis in his late 40 s. After some years, he developed leukoplakia, which can be a precancerous condition. By the time that I saw him, he had had six surgical removals of the raised white patches from his vocal folds; each time they were checked for malignant cells and found to be clear. Although, when I first met him, his vocal folds were clear of disease, his voice was extremely rough, breathy and constricted. He had developed a secondary voice problem, with a very strained pattern of phonation as he struggled to ‘push out’ a strong lecturing voice. Daily steam inhaling and a thorough training in strong lower breath support and deconstriction resulted in a greatly improved voice quality after only two sessions. Sadly the leukoplakia did eventually prove malignant and he had to have his larynx surgically removed.

Vocal fold cysts Cysts are fluid-filled sacs that can occur anywhere in the soft tissues of the body, including the vocal folds (Figure 27.4). Depending on its position, it may interfere with smooth vibration, so the voice may sound rough, or may prevent clean closure of the vocal folds, and the voice will sound breathy. Most cysts will need surgery to remove them.

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Figure 27.4 Bilateral vocal fold cysts. (Reproduced with permission of Mr Tom Harris.)

Voice story: Emilie Emilie was a young and sociable medical student, who told me that even as a child she had tended to become hoarse as she ‘talked so loudly’. She was referred to see me with a diagnosis of large, soft vocal nodules and, after 3 months of voice therapy, her voice was much better though not yet normal. She had become so interested in voice disorders that she decided to do a special study assignment on the topic. I invited her to come to a voice conference, during which eminent French phoniatrist Professor Guy Cornut asked for individuals who would be willing to be examined. Emilie volunteered, and was surprised to be told that she had no nodular swellings, but two distinct intracordal cysts. There had been no misdiagnosis the first time; the nodules had developed because she had been forcing her voice through the effects of the cysts. Once they had subsided, the original and probably congenital cysts could be seen. With a gap of 6 months between operations, Emilie had both cysts removed and her voice became normal.

Papillomas Papillomas are benign growths that occur on the vocal folds, and sometimes elsewhere in the larynx and trachea (Figure 27.5). They are thought to be linked to a wart-type virus. In young children they can be life threatening, because they can be so abundant that they block the airway, and need repeated surgical removal or even a long-term breathing tube in the neck. In adults they can recur with monotonous regularity and can cause severe voice disturbance. They may need frequent surgery; one client developed a new patch of papillomas in the 4 weeks between his previous laser removal and his first appointment with me.

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Figure 27.5 Papillomas. (Reproduced with permission of Professor Martin Birchall.)

But there is great variability in occurrence and, similar to warts, papillomas may suddenly stop forming. It also seems possible that there is a hormonal influence because they may cease at puberty or pregnancy, and recur at menopause. There is as yet no cure, but nor is there any danger that papillomas become malignant. Voice therapy aims to maximise vocal sound and minimise anything that might strain the voice.

Voice story: Kanchan Kanchan was a young 28-year-old female barrister, who had six surgical removals of papillomas in 2 years. Voice therapy worked to give her the best quality voice possible, and she made good progress during the first four sessions. However, this was interrupted by another need for surgery, 4 months after the last removal. Knowing that a strong immune system could only help her general condition, she took various proactive steps in terms of complementary medicine, diet and exercise. We discussed this and, accepting the adage that ‘nothing ventured, nothing gained’, we also tried out some active visualisation techniques, to imagine the larynx and vocal folds completely white and clear. Much to the surprise of both of us (and quite accepting the unpredictable random nature of papilloma) she remained papilloma free for 18 months, when a much smaller patch was removed. She became pregnant a year later and 6 years later remains free of any recurrence.

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Paralysed vocal fold The movements of nearly all the laryngeal muscles are supplied by the left and right recurrent laryngeal nerves, and if either of these is damaged a temporary or permanent vocal fold weakness can result. This can occur in certain illnesses (including ordinary flu, though this is rare), trauma, tumours and sometimes after thyroid surgery. If the paralysed fold lies in an open position, the speaker’s voice will probably sound breathy and lack power, while his cough will be weak. Pitch and pitch range may be impaired, and there may be diplophonia – literally a ‘double note’ – as the folds vibrate at different speeds. If the affected fold is fixed in the midline position, closure can still happen but, as there is no normal mucosal wave, quality and pitch may be impaired. In rare cases both folds may be paralysed in the midline position so that they are almost closed; this creates a real medical emergency because normal breathing cannot take place, and an immediate and sometimes permanent breathing tube is needed. The cricothyroid muscle, which lengthens the vocal folds, is the only muscle supplied by the external branch of the superior laryngeal nerve. If this is damaged, there will be problems in raising the pitch and pitch control generally. Voice therapy aims to improve the voice as much as possible, but, depending on the cause, there is often a spontaneous improvement in a vocal fold paralysis in the first 6–12 months. If there is no improvement with time or exercises, there are various surgical options to improve the voice.

Voice story: Nick Nick was a healthy 45-year-old plumber, who was surprised to find that, 7 weeks after a severe bout of flu, his voice was still very hoarse and weak. He thought that he had strained it before he fully recovered from coughing, but ENT examination found that he had one completely paralysed right vocal fold, set in an open position. He came to see me nearly 3 months after the problem had started, at which point his voice was still very rough, breathy and strained. Voice therapy started by showing Nick how to use head and neck positions and lower breath to support his voice. We then worked on exercises to help the stronger fold to compensate and the weaker fold to stretch and strengthen as much as was possible. After three sessions, Nick was able to make better use of the voice he had, and over the next 6 months his voice naturally returned to its normal quality.

Spasmodic dysphonia/laryngeal dystonia In this disorder, the flow of voice is interrupted by irregular spasms, with a jerky, strained and strangulated quality. In the most common form the vocal folds suddenly and frequently snap closed, but occasionally the folds may spasm into an open position, or there may be a mixture of the two patterns. The cause used to be considered as emotional stress, and many clients were given ineffectual voice therapy. There are rare cases of a psychologically

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caused spasmodic dysphonia, often linked to a precipitating trauma or stress, but there is usually a neurological basis for the true spasmodic dysphonia. It is a specific or focal kind of dystonia – a disorder of muscle tone in which uncontrollable tremors or spasms can occur, such as repetitive twitches heads, eyes or jaws. Some ENT surgeons and SLTs have specialist expertise in the diagnosis and treatment of spasmodic dysphonia, but elsewhere there are still frequent problems with misdiagnosis. Although it can occur in young people, spasmodic dysphonia generally develops in middle age, and Mathieson (2001) estimates that there may be 2000–3000 people with the condition in the UK. Voice therapy may help support the client and improve the voice by reducing strain, but all voice practitioners should be aware that nothing that they can do will cure the true spasmodic dysphonic voice. The effective treatment nowadays is by injections of botulinum toxin (Botox) into the vocal folds, to weaken their closure patterns. Sometimes spasmodic dysphonia is confused with benign essential tremor, a less severe but still debilitating vocal feature. In these cases, instead of the often-irregular tight spasms, there is a regular and usually consistent ‘shaking’ in the voice. It is most likely to appear in the older speaker, and is rarely cured by voice work.

Other neurogenic voice disorders Neurogenic voice disorders occur when there is a problem with the central nervous system (the brain and the spinal cord) or the peripheral nervous system (the nerves that run from the spinal cord to the muscles or organs that they supply) that connects to the power or coordination of voice muscles. These disorders are usually part of a general condition. Box 27.2 shows how the Voice Skills Framework can be used to identify areas for work and to explore the voice of a client who has Parkinson’s disease. The client was given 4 weeks of intensive training in the Lee Silverman method (Fox et al 2002), which resulted in a clear improvement in his voice.

Cancer of the larynx Many clients with hoarse voices worry that their diagnosis may be laryngeal cancer, but this is still relatively uncommon: 2166 cases were recorded in the UK in 2004, which is 3.6 for every 100 000 people (figures from Cancer Research UK website, accessed 2008). It is most likely to occur in older men and women who have been heavy smokers and drinkers, but occasionally occurs in younger clients. Laryngeal cancers can occur below, on or above the vocal folds, and early diagnosis of a cancer actually within the vocal folds generally has a good prognosis for total recovery. Different methods are used to destroy the cancer. These include laser removal of the tumour, radiotherapy, or the major surgery of a partial or total laryngectomy (removal of the larynx). If the cancer is extensive, other nearby structures may also have to be removed. After a laryngectomy, breathing through the mouth is no longer possible, because there is no link between this and the lungs. Instead air enters and leaves through a hole (a stoma) in the neck. Swallowing, speaking and breathing are all affected, and it affects many aspects of a speaker’s practical and personal life.

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Box 27.2 Mr HS: Voice Skills Framework in Parkinson’s Disease Mr HS (aged 78) Speaker’s own words about his/her voice: ‘My voice doesn’t carry like it used to, there’s no power, and I stutter and stumble.’ 1 Body: posture, movement, muscle tension, vocal tract sensation, health and body Face fairly impassive. Says he is generally stiff and lacks easy movement – severity varies – medication affects. Swims regularly in local pool and always looser after this. He and his wife used to love ballroom dancing. All shoulder, neck and extrinsic laryngeal muscles are very tight – HS says that this is worse since the onset of Parkinson’s disease 3 years ago. Rates himself as 6–7 on the physical–emotional tension scale; says he has always been a worrier and does get anxious. 2 Breath: placing and control Upper chest breath pattern of breath – fairly quick shallow breath intake, but not markedly abnormal. Sustained sssss = 16 seconds. Sustained zzzzz = 16 seconds. Potentially good breath control/support but not using it well – vocal energy ‘drops’ towards end of sentences. 3 Channel: face, lips, jaw, tongue, soft palate, pharyngeal, laryngeal Lip opening and closure is fine but limited range of movement in speech with minimised rounding and spreading. Close jaw setting with limited range of movement. Tongue movement more limited than that of lips and jaw; vowels ‘narrow’ and consonants imprecise. No noticeable hypernasality, and no reported swallowing problems. Not marked laryngeal constriction but a slight quality of ‘push’. 4 Phonation: rough, breathy, creak qualities, phonatory stamina and other features Generally only a slight roughness in spoken voice and within normal range but irregularity does noticeably increase when he produces louder voice. Breathy throughout speaking – makes phonation sound slightly ‘whispery’ in quality. Creak is only occasionally present and quite normal. HS says his voice does feel and sound fatigued and weaker by the end of a day when he is tired, but this is also greatly affected by his level of medication. He has been a keen choir singer in the past. 5 Resonance: features of head, oral and chest resonance and focus of oral placing No marked imbalance but sense of a lack of ‘ring’ – lacks head resonance quality. Increasing this might help voice carry. He was able to produce a surprisingly loud and strong hum, and said that he felt a strong sensation of a tingle between his lips. 6 Pitch: centre, range and intonation patterns/variety Centre pitch normal. Pitch range and control is interesting area – HS says his wife reports that he sings as well as ever in church, and he certainly has accurate pitch control and alteration in tasks, though he does sound rougher and strained at higher pitches. However, in ordinary speech he has a noticeably limited range of intonations and this became more so as session progressed, and he became more tired.

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7 Loudness: overall loudness level, variety and control, and use in emphasis Overall loudness level is certainly low but not severely so and he can produce very loud voice when asked on long vowel or phrases – uses significant effort with laryngeal strain. Limited – range of loudness has little variety in ordinary conversation, or between the ‘moderate’ and ‘very loud’ levels of the three heys task. Limited word emphasis. 8 Articulation: consonant and vowel clarity, pace, pause, fluency, rhythm Imprecise consonants – he estimates he is intelligible 75% of the time – it was higher in the session but there was no background noise. Minimised tongue movements probably cause of a closer setting for most vowels and ‘clipped’ diphthongs. Says his pace is slower than before but I wonder if this is his impression of more ‘laboured’ speech, as today the speed was slightly too fast and did not help intelligibility. In surgical voice restoration after laryngectomy, a small channel (a fistula) is created between the trachea and the oesophagus, and a small one-way valve inserted. This enables air from the lungs to be used to vibrate a narrow part of the oesophagus (the pharyngooesophageal or PE segment). The person can again use ordinary breathing to power this new method of voicing. However, the valves need considerable care and management by client and skilled SLT or nurse. There are other ways that people can communicate after a laryngectomy. Some clients use electronic communication aids; these are continually improving but their quality still has some way to go until it truly sounds like a human voice. Others will master the technique of ‘oesophageal voice’ where air is ‘injected’ via the mouth into the eating tube. The voice emerges a little like an artificial belch, but control of this new voice can become very good. The sound is then shaped into sounds and words in the normal way by the usual articulatory muscles. Voice therapy for laryngectomy clients is a specialised area. Cancers can also occur at other places in the vocal tract, including the pharynx, palate, lining of the mouth and the tongue, and various aspects of the voice will invariably affected by both structural changes and pain. The specialist treatments may include radiotherapy, chemotherapy or surgery.

Two examples of voice therapy These stories are included as examples of two different approaches to the treatment of functional voice problems.

Muscle tension dysphonia: intensive practical work Pamela was the teacher whose story is described in Chapter 6, where her two Voice Skills Perceptual Profile (VSPP) scores showed her improvement with voice therapy. Below you see a summary in note form of the work that took place during the third 1-hour-long session.

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Previous work had included attention to body issues, such as general tension and fitness levels, water intake and steam inhaling. We had also begun to establish a new lower breath placing. The focus of this session was on hard energetic work, what I sometimes describe as a ‘vocal gym’ visit. 1. General talk and discussion about how her voice has been, and her incorporation of the breath technique into ordinary life. 2. Reminder of the lower breath/voice connection: mm, mm – several times, with one hand above and one below the waistband. uh huh, uh huh; counting in various forms; repeated sentences; reading; conversation. 3. Build up breath control and length of utterance without throat constriction: Progressively longer counting out loud, e.g. 1, 2, 3, 4, 5, 6, 7, 8, 9, and further in sitting, standing and moving. Counting exercise 1–15, several times, in a chatty manner – letting breath ‘drop in’ quickly and silently at end of each group, to reduce audible gasping. 4. Make sure that the channel has minimal constriction: Jaw-drop test and release. Yawn–sigh. Whispered haa – with excess tension/constriction and then open sense to feel and hear the contrast. Laryngeal deconstriction by exploring and feeling chest resonance, and then reducing it. ‘Village ghost’ on loud, open throated aah. ‘Cosmic cow’ on loud mmm. 5. Phonation – tune into, and avoid hard voice onset: Whispered haa moving into voiced haa – several times; counting with alternate hard/ breathy onsets. Counting with balanced voice onset, then words, phrases incorporating ‘healthy’ breath, channel and phonation settings. 6. Introduce idea of use of slightly increased head resonant quality for projection. Contrast head and chest resonance in ‘No! Mean! He’s so mean!’ Use head resonance in sentences – ‘Listen to me! Sit down quietly and open your books.’ Use in self-generated ‘typical’ teaching sentences. 7. Encourage release of excess laryngeal constriction, vocal fold flexibility and use of wider pitch range. Use giggle; operatic laugh down range; bleat; sirens; speaking words and sentences up and down the range. 8. Reminder of abdominal connection for loudness: Strong Hey! Hee! Wow! Wooh! Weeeh! Allelujah! Calling – Yoo hoo! Anyone home? Are you coming? We’re going to be late! 9. Build up loudness towards end of long sentence without constriction. Counting exercise again, this time with crescendo towards end of each group. Phrases and sentences – each repeated five times with increasing loudness and no strain.

Psychogenic aphonia in a child: three sessions This is an unusual story of a child who developed a complete aphonia. The sessions show the mix of physical and emotional approaches needed in all cases, whether adult or child.

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Josh was a 9-year-old boy who had sung solo in his school choir in a carol concert on a Thursday evening. Over the weekend his throat was tired, sore and ‘a little bit hoarse’. On Monday his mother said that he felt dizzy and was off his food, so she kept him at home ‘to look after him’. He had recovered by Wednesday and continued at school until the Friday, the end of term. However, the following Monday (i.e. 10 days after the original voice strain) he woke up with no voice and an ache in his throat, but no other symptoms. Since then he had only been able to speak in a whisper. ENT examination found that his folds looked normal and moved normally in coughing, but did not close at all in speaking. By the time I saw him he had been voiceless for 8 weeks.

First session Josh arrived with his mother, who stayed in for the whole session, and I took a detailed history asking questions from both of them. Josh whispered that he thought that he had hurt his voice with his strong singing. However, although he had had vocal strain and a viral infection, the suddenness of a later complete voice loss was not typical of a muscle tension dysphonia. Josh’s main worry was the significant pain around the base of his larynx, and his mother said that they had briefly mentioned it to the ENT consultant, who did not seem concerned. This degree of discomfort was unusual in so young a client, and I silently wondered if it might link to some emotional pain. I told Josh that his voice muscles were probably just strained and cramped because he was having to push a whisper out, and he looked visibly relieved. I gently felt his neck muscles with my hands, and found that he was very tender around the larynx, and in both sternocleidomastoid muscles. I reassured Josh that he would get better, and told him that I would first help his muscles to ‘uncramp’, and would ‘tuck him up on the floor’ to give his neck ‘a rest’. I asked him to lie on the floor in the semi-supine position, and covered him with a warm red rug. I took him through some shoulder and neck tighten-release work, and focused his breathing low under his hands, which were lying on his stomach. After a series of deep sighs and yawn sighs, where he could feel his throat was open, we did some long shh and fff and sss sounds but no voicing. ‘Good,’ I said, ‘that’s a lovely easy flow of air through your throat.’ Once he was relaxed, I asked him to make some gentle throat-clearing sounds, feeling his tummy move in as he was doing so. These sounds had completely clear phonation, but I could not enable him to use that in any deliberate sound, so left this strategy. Changing direction, I explored whether he could produce voice on an inspired breath, and he could immediately do this with no difficulty. I took him through a simple sequence: 1. Inspired voiced haa sounds. 2. Short voiced inspired hiccup sounds – huh huh. 3. Inspired huh followed immediately by the same sound on expired air. Although hard at first, this got progressively easier. We laughed at the oddness of the sound, and Josh began to get full phonation with little effort. We then stopped doing voice on inspiration, and used just the out-breath on hmm, mmm, mm-one mm-two mm-three mm-four – and so on up to ten. I then moved him into counting with no mm before each number. By this stage Josh was using quiet normal phonation. I had been sitting on the

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floor by him, and moved us both upright, stretching and shaking our legs and arms to loosen the muscles and generally ‘liven up’. When we sat down and did a few of the exercises in a sitting position, Josh kept his full voice in the exercises but it went back to a whisper when he spoke to me. By this stage he seemed tired, so I gave him a glass of water and reassured him that his voice was beginning to come back. As she left, Josh’s mother said quietly to me ‘it’s such a relief for me to hear his voice again, because I’ve got a lot on my plate to deal with, and that’s one less worry’. We agreed that Josh would do some practice with a quiet, clear mmm, as he could reliably get full phonation on this sound. This was to reinforce the sense that he could control his voice on his own, and that it did not depend on being with ‘the speech lady’.

Second session – 1 week later Josh was again aphonic when he arrived and we talked about how things had been going. His mother said that his voice was perfect in exercises but non-existent in talking. He had been in more pain than usual in the 2 days after the last session, but it was now better. I wondered whether this could be a resistance to getting his voice back, but told them that sometimes the muscles battled between the old strain pattern and the rediscovered released pattern, and he would have less pain once the voice came back. We agreed that Josh’s mother would not watch this time, so she went into the waiting area. Josh sat comfortably, and as I used my hands to work on the muscles at the front and sides of his neck, I could feel them loosening. Keeping my warm hands on his shoulders, I asked Josh to let his jaw drop and imagine the whole area of his neck softening and relaxing. He said ‘it feels nice’. I then asked him to make a clear mmm on a falling pitch. This he was able to do perfectly several times so I said ‘that’s great Josh, we’ll be able to get your voice back this session’, instilling in him some new confidence. We worked delicately from mmm plus vowel into sounds like ‘me’, ‘mow’ and ‘my’. ‘Those are real words,’ I said, ‘let’s try some more.’ Josh was then able to repeat any word I said. Having built confidence in repetition, I moved on to asking him to name objects in the room, and then to answer questions needing one-word answers, and whole sentences. At no point did his voice falter. We stood up, stretched and used our arms to ‘punch the air’, to the accompaniment of loud heys. These were designed to distract Josh from the deliberate vocal effort he was making, and to connect him to his body energy. I then introduced a loud ‘Tarzan the Jungle Boy’ sound, accompanied by chest beating. It was designed to make him laugh – and did – and we began to explore a much stronger, open throat sound. We then moved into ordinary chatting, about what he liked to do at home, and Josh kept his now normal voice. He suddenly told me that his 12-year-old brother had started to hit him before Christmas, and was now sometimes hitting him quite hard. I used simple cognitive–behavioural strategies to explore Josh’s thoughts, sensations, emotions and behaviour when this happened. He said that he felt helpless; he did not try to fight back but just went to his room and said nothing to his parents. We talked about what he might do when it next happened. As we talked, his voice occasionally slipped back to being aphonic and I would ask him to go back to the mmm which immediately restored it. Josh called his mother into the room and she was delighted with his strong voice, though she commented that it was more ‘little boy’ than usual, which I found interesting. I suspected

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that this was a mixture of physical factors (raised larynx and still some tight shortening of the folds) and possible emotional factors (will I still be looked after?). I asked Josh to tell me about his visit to Disney World, so that his restored voice could be associated with a pleasurable topic as he got more used to it. We also talked about how he might look after his voice, e.g. not to whisper if he felt tired but just be quiet. I wrote a note to his teacher about his need for occasional silence, as I felt that this might give him the permission to still ‘be special’ at school. I told Josh’s mother that I would call in 5 days, at an agreed time, to find out how things were going. If the pain was still a problem, I had decided I would suggest that we discuss the option of special osteopathy at the next session, which we set as being 2 weeks later.

Check-in phone call Our phone call took place when Josh was at school. His mother told me that his voice was strong and he had no neck discomfort. She said that she had feared Josh’s voice problem might be connected to the ‘tough time’ that she and her husband had been having, as they had even discussed separation. They had not talked to the boys about it, but she felt that they suspected. Josh tended to ‘just go quiet’ when upset, and she knew that his brother had been ‘very grumpy’ recently. In the last few days, Josh had told her about the hitting (a strategy that we had discussed). Previously the boys had always got on well. Josh’s mother had been very stressed with her work and her marriage, and said that she never seemed to have time with the boys for fun or to talk.

Third session Josh arrived smiling and using a completely normal voice. I knew that this would probably be our last meeting and wanted Josh’s mother to stay in for the session, so that they could have a sense of partnership in connection with his voice. She said that Josh’s voice had remained clear except for two occasions – after an unusually long school day and when he had shouted at his brother for messing up his room. On this latter occasion, his voice had become ‘squeaky and hoarse’ for several minutes, but, as he calmed down, his voice came back. This seemed a good opening for me to sensitively introduce the idea that how we feel can also tighten our muscles, which I did by demonstrating how my voice could sound if I felt ‘choked up’. I did this so that Josh would not feel abnormal in his voice problem, and we were then all able to talk about how everyone sometimes gets tense about life. At no point did I refer to their specific situation. It is, however, sometimes easier to say sensitive things to someone in front of a third party; Josh’s mother looked straight at her son, and said: ‘You know dad and I have been arguing a lot recently, and I wondered if you get worried about that?’ Josh looked very upset, and said ‘I do worry a bit’. I stayed silent but focused intensely on them both. Josh’s mother said that they would talk with his dad and brother that evening. When we spoke on the phone a month later, the marriage was still having problems but they were all ‘working on it’ and Josh’s voice had remained normal.

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Recommended books Aronson, A.E. (1990). Clinical Voice Disorders. New York: Thième Stratton. Colton R.H. and Casper J. K. (1996). Understanding Voice Problems: A physiological perspective for diagnosis and treatment, 2nd edn. Philadelphia: Lippincott Williams & Williams. Mathieson L. (2001). Greene and Mathieson’s The Voice and its Disorders, 6th edn. London: Whurr. Merati A.L. and Bielamowicz (2006). Textbook of Voice Disorders. San Diego, CA: Plural Publishing, Inc. Rubin J.S., Sataloff R.T. and Korovin G.S. (2006). Diagnosis and treatment of voice disorders 3rd edn. San Diego, CA: Plural Publishing, Inc.

Chapter 28

The daily working voice

Professional voice users Nearly everybody uses voice at some point in a working day. Factory workers speak to colleagues, gardeners, cleaners, jockeys and refuse collectors convey information; fishermen, soldiers, sailors, librarians and lorry drivers communicate action, and musicians, poets and accountants rise from their instruments, paper or computers to meet and speak. But if any members of this group found their voices impaired or lost through laryngitis, they could still perform their work. Other professions such as supermarket cashiers, airline pilots and hospital administrators can work with a disturbed voice, but this limits their effectiveness. My clients have included an academic librarian with heavy teaching duties, a building site manager whose voice would not carry outside, a cleaner who struggled to direct her team, and the Mother Superior from a silent order of nuns whose deep ‘bluesy’ voice could not reach the high notes of her daily choral singing. For some workers, a disturbed voice actually stops them from carrying out their job. Their daily bread depends upon their daily working voice. Sataloff (1997) writes that, although professional voice users ‘span a broad range of vocal sophistication and voice needs they share a dependence upon vocal endurance and quality for their livelihoods’. Their voices have to be reliable tools with qualities specific to their work demands. The demands on professional voices can be extensive and depending on the group, may include: • • • • • • • • •

long periods of speaking time the need for high loudness levels varying acoustic spaces cramped or immobile body postures varying air quality atmospheres high levels of background noise no option for microphone a requirement to come across to listeners as strong, interesting and fluent dramatic variation needed to inform, persuade, inspire and control others

Voice Work: Art and Science in Changing Voices. Christina Shewell © 2009 Christina Shewell. ISBN: 978-0-470-01992-4

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• • • •

a need to express a range of emotions in dramatic text a need to respond to a range of emotions in listeners particular singing skills for particular styles an ability to speak or sing even if physically or emotionally unwell.

Carding (2007) says that ‘it has been estimated that around one-third of the work-force in the developed world relies on their voice to do their jobs’. But apart from the performer group, most professional voice users receive little or no voice training for the intensity or quality of their voice use. Good voice training helps protect the voice from strain and damage, and can improve the way that a speaker comes across to others.

Incidence of voice problems in professional voice users Most of the hard evidence about the incidence and causes of voice problems comes from Sweden and the USA. Fritzell (1996) looked at 1212 Swedish workers with voice disorders and found that teachers headed the list, with social workers, lawyers and clergymen also over-represented. In an American survey, Titze et al (1997) compared overall US workforce population numbers with the proportions of professional voice users attending Wisconsin voice clinics. Below you will see a sample of their interesting findings: • • • • •

Counsellors (0.2% of the workforce) formed 1.6% of the clinic caseload. Telephone marketers (0.78% of the workforce) formed 2.3% of the clinic caseload. Salespeople (about 1.3% of the workforce) formed 3–4% of the clinic caseload. Singers (0.02% of the workforce) formed 11.5% of the clinic caseload. Teachers (4.2% of the workforce) formed 19.6% of the clinic caseload.

A number of other studies have found that teachers form the largest proportion needing clinical voice support. A Finnish study found that 42% of their teachers reported regularly occurring troublesome voice symptoms and one in ten had vocal nodules (Smolander and Huttunen 2006). Although voice problems precipitate early retirement for some teachers, there have been only a few court cases where a teacher has proven long-term damage caused by the specific nature of her work. Carding (2007) says that the scientific evidence is not yet ‘robust’ enough in this field and ‘it will be necessary to demonstrate a doubling of risk in the occupations with particular exposure to conditions likely to result in voice disorders’. As the causes of most voice disorders are multi-factorial, it is hard to definitively state that a job causes a voice disorder. There is no such thing as an ‘average’ professional voice user, because the demands vary according to work environment, training, the specifics of the job, relationships with colleagues and other factors. There is, as well, the added variable of the tapestry of personal life that wraps around and into every professional voice user. Although they may not earn their living through the use of their voice, work with amateur public speakers will be similar to that with the professional voice user. Some public speakers address large groups in a non-work capacity, perhaps as regular chair of a local organisation or at occasional personal ‘one-off’ events such as a family ceremony. Sometimes an interesting and unexpected link is made between professional and amateur speaking.

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Voice story: company director When working with some middle managers at a large company, the human resources director told me that her CEO (chief executive officer) had asked to see me at the end of the day. He was a successful man in his mid-50 s, who told me that, although quite comfortable in work presentations and when speaking as chair of two national organisations, he always had to read his script word for word. ‘I’ve got quite good at that,’ he said ‘and I know I’m not a boring speaker.’ However, he now had to make a speech at his son’s bar mitzvah, where there would be around 500 people. In this emotional atmosphere he really wanted to be able to speak with no script, so that he could tell the story of his son’s life and talk about his feelings without reading. We worked together for a couple of sessions and he managed the important day with just minimal headings of his main points written on a single card – which he did not have to consult. After that, he used the same strategies in his professional work. Some months later the same HR director told me that it had made a significant difference to his presentations because ‘he was never dull, but he sounds so much more real now’.

Protection strategies and extension skills Work with professional voice users involves both protection and extension skills, to different degrees with different groups. Although voice therapy from a speech and language therapist will be needed if a worker develops a voice disorder, other voice practitioners can often offer all or any of the voice care protection strategies described in Chapter 16 and these may help to prevent vocal fold damage. The suggestion that a dry-throated auctioneer should increase fluid intake and air humidity can provide much needed hydration for the vocal tract. A secondary school teacher having regular singing lessons may mention that her voice is often tired and hoarse at the end of a week. If that singing coach can show the teacher how she can use aspects of breath, resonance and articulation to help the carrying power of her working voice, he is helping to remediate a situation and may prevent a later medical referral. Some training in vocal protection would ideally be available to every one of the professional voice user groups. A recent article by Casper (2007) describes how research has shown that ‘even the act of daily phonation causes a mild superficial layer vocal fold tissue injury, a repetitive stress injury’. If this is true of normal use of the voice, it is clearly very important to protect any vocal folds required to work harder than others. A basic understanding of voice production and care can give a speaker the tools to protect his voice from strain and is cost-effective, because ‘vocal problems can affect careers and reduce profits for a company’ (Titze et al 1997). In extension skills, we train someone so that he may further develop his natural communication abilities. The young barrister learns to use a more dramatically interesting style of delivery and finds that he can speak without having to stop mid-flow to gulp some water. The aspiring politician finds that her singing lessons give her new power and energy in her spoken voice, and listeners notice how much stronger she sounds.

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Protection and extension skills are not synonymous, and workers vary in whether they need one or both. In the business world, individuals often want to sound more interesting, more powerful or more ‘themselves’. Provided that the speaker has no symptoms of vocal strain or ill health, basic pointers on specific protection strategies will be relevant, but the main business will be on issues such as managing nerves and the development of presence and communication skills.

Shared principles for health and daily working voice Healthy body use, posture and tension levels are at the core of the free voice. Many of these principles and practice are shared by the field of stress management, and so relevant for all workers, not just professional voice users. Excess muscle tension and musculoskeletal problems affect huge numbers of people around the world, with wide ranging results. A 1999 European Commission survey found that a third of all workers suffer from backache, and the number of musculoskeletal disorders in the USA increased fourfold between 1987 and 1992 (Lundberg 2003). ‘Time pressure, lack of influence over one’s work and constant involvement in repetitive tasks of short duration often characterize jobs associated with a high risk for muscular problems.’ He concludes that ‘several studies indicate that lack of relaxation during and after work may be of significant importance for the development of musculoskeletal disorders’. Movement and voice workshops that facilitate the release of physical and emotional tension could be of benefit to all workers – vocal or silent – and could effectively form part of work-place stress management programmes.

Six professional voice groups Table 28.1 shows the six main groups of professional voice users, organised according to the nature of the demands on their voices. The name of each group refers to a prime motivation for their voice use. The motivations are not exclusive but are a guide to each group’s core vocal demands. Of course there are many crossovers, and some workers change motivation roles throughout a day, others as they move through their careers. This chapter describes voice work priorities for each group. Voice care and practical work can be selected from Part 5 and from the recommended books at the end of the chapter. When working with any group or individual, an early period of discussion about the job’s vocal or communication skill demands or clarifies the context for the work needed.

Group 1: supporters • Typically: long use of voice, often low loudness levels, usually one to one, often dealing with high emotional stress levels in others, need for sensitivity and listening skills. • Examples include: social workers, probation officers, voice practitioners, psychotherapists and counsellors, solicitors, nurses, doctors, bank and financial advisers.

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Table 28.1 Table of professional voice user groups.

Group

Details

Examples

Group 1: supporters

Long use of voice but with frequent silent periods for listening; generally quiet loudness levels; usually one to one; sometimes dealing with high emotional stress levels in others

Social workers Voice practitioners Psychotherapists and counsellors Market research interviewers Travel agents Nurses and doctors

Group 2: callers

Short bursts of high loudness utterances, some over very high background noise. Bad weather conditions, smoke or other fumes may be an additional factor

Army drill sergeants Bar, club and pub staff Stock exchange traders Auctioneers ’Outdoor’ workers Policemen and women Shepherds Football coaches

Group 3: transmitters

Long use of voice with microphone and headphones; often high stress with possibility of verbal abuse from listeners; little body movement variation

Call centre enquiry workers Receptionists Telephone sales workers Station and airport announcers Sports events commentators

Group 4: informers

Long periods of uninterrupted speaking to varying size groups and in large spaces, as well as to individuals. High level of responsibility for group, with need to be able to use voice to inform, persuade, inspire, etc.

Teachers Lecturers Aerobics instructors Spiritual directors such as rabbis, clergy, mullahs Professional story-tellers

Group 5: leaders and sellers

Generally shorter periods of uninterrupted speaking than group 4, but an important relevance of dramatic use of the voice to influence people; high loudness levels at times

Business leaders and managers Sales people Managers in institutions Politicians Judges Barristers Theatre, film, TV directors

Group 6: performers

Long periods of high-energy voice use; often to large audiences; high level of skills needed to interpret and convey emotional content, words and/or music written by others. Varying body positions needed. Usually some vocal skills training

Singers Actors Stand-up comedians Broadcasters in radio and television

Voice care This should include an emphasis on hydration, encouraging enough fluid intake and also possibly the use of a simple humidifier in a regularly used consulting/interview room if the atmosphere is dry, and the voice user feels that this may affect the sensation in his throat.

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Voice work These professions often have long periods of sitting still and listening, sometimes absorbing other people’s body tensions and emotions. Deliberate stretching, shaking and muscle rubbing, or a period of floor work in longer breaks, can help to release any build-up of ‘quiet tension’. Lower breath work will help to support the voice over long periods of time, and can also help with any inner tensions. It is interesting that the US and Swedish research (cited above) found that social workers and counsellors frequently appeared in voice clinics; these groups are not required to use high loudness levels, and this suggests that the vocal strain issues are more subtle and likely to be related to emotional and body stress. As part of his work, a senior police officer with a missing persons’ unit had to tell relatives when the death of their family member was confirmed. He told me: ‘It’s like a drainage system, I still feel all my energy going into them’ – a graphic image for his bodily feelings. Stress and concentrated listening can also exacerbate any habitual tendencies to an overtight channel; a voice practitioner can point out the habitual areas where this can happen and suggest quick releases between clients, e.g. ‘pulling faces’, jaw release work or general pharyngeal/laryngeal deconstriction. Occasionally insecure students in the supporter group develop a particular vocal style in their work, the characteristics of which often include a slightly raised pitch mean, unusual amount of breathiness and an over-extended pitch range with a heavy use of falling intonation pattern. Such stereotypical voice qualities can be used unconsciously as a kind of protective vocal mask, but will come across as patronising and emotionally distancing, and does not help the healing relationship. I sometimes demonstrate this vocal style to SLT students, pointing out that, if a therapist uses an artificial voice to suggest sympathy and understanding in her work, she will not sound – or feel – authentic. Other voice skill misuse can create communication barriers. I went recently to discuss a mortgage issue with a bank’s financial adviser, an able and helpful man in his mid-30 s. I was there for an hour and in that time his volume level was consistently up around the 7/10 level. It was too loud for comfort, with minimal variety, and left me feeling rather battered and less reassured than I should have been. It was not appropriate to say this to him, but in voice training such issues would be pointed out.

Group 2: callers • Typically: short bursts of often loud or strong utterances, which may be over very high background noise or in the open air. The voice may have to be used in an atmosphere of smoke or other fumes, or in varying adverse weather conditions. • Examples: army drill sergeants, bar, club and pub staff, stock exchange traders, auctioneers, ‘outdoor’ workers.

Voice care Adequate hydration is important for all groups, and certainly so for those who have to use their voices very loudly. Ian Kershaw (1998) describes Hitler’s extraordinary hydration needs. ‘Hitler made his first speech to the fledgling Nazi party in October 1919, heard by

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an audience of 100. Word of his charisma got around. Within four months he was attracting crowds of 2000. They were drawn to a man whose histrionics were such that he lost pounds in a single speech and had to have 20 bottles of mineral water on hand to replace lost fluid.’ Few callers will need to match that level of physical and vocal energy, but they will need to be aware of voice awareness and protection strategies. After-care of voices can also be important, e.g. steam inhalation after a long and loud work period can be soothing for the throat and vocal folds.

Voice use A priority for this group is to be able to use a strong and often loud voice with no strain. Core to this are a firm, symmetrical body posture, and strong breath support with an unconstricted channel and larynx. All aspects of voice projection (described in Chapter 13) are relevant, particularly the use of posture, lower breath and forward oral resonance placing. New skills can be incorporated by working with suitable dramatic texts that need strong voice power. Even a short intensive training with a voice practitioner can give callers the understanding and experience needed to develop their voice use.

Group 3: transmitters • Typically: long use of voice through sound system and headphones, frequently interruptions to speaking, little body movement variation, sometimes needing to deal with strong emotions from speakers whom they cannot see. • Examples: call centre enquiry workers, receptionists, telephone sales workers, station and airport announcers, sports events announcers.

Voice care Call centre operators are a relatively new profession but there have been a number of academic and general media reports on the demands of their jobs, and their voice use is probably the heaviest of this group. The Voice Care Network (UK) estimates that 500 000 people are primarily employed in telephone work in the UK. Finnish researchers Lehto et al (2005) found that female telephone workers frequently experienced hoarseness and a feeling of vocal strain and mucus in the throat. Explanation, video material and demonstrations can all help to demystify these often worrying symptoms, so that people immediately feel less helpless and more in control. Advice about increasing fluid intake and humidity is always relevant, as is some discussion about long-term sitting postures and general body care. Workers vary in terms of the length and regularity of their breaks and where these are taken, but regular body stretches and loosening movements can help release excess muscle tension.

Voice use An awareness and use of lower breath placing will support the long use of voice, and regular deconstriction exercises can help prevent a build-up of vocal strain. Along with supporters

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and callers, most people in this group are unlikely to want to carry out long practice, so I always suggest a range of ‘instants’ – the simple, quick actions done at socially appropriate moments during the day to help to release tension, tone muscles or encourage vocal flexibility. Examples are made specific for an individual but might include: • • • • •

facial muscle stretches three short shh sounds with deliberate quick abdominal muscle contraction ten jaw openings and closings, or the jaw drop five quiet sirens up and down on a long ngg sound the thin fold whimper.

Voice story: Jenny Jenny worked as an administrator at a car insurance call centre. In the first few weeks after she transferred to answering customers’ calls, her voice worsened in quality and comfort throughout the long day. She developed a habit of frequently clearing her throat because she felt permanently that she had too much phlegm. Her ENT examination found that she had swollen, slightly inflamed, pink vocal folds. At our first session my explanation pointed out that she had to talk for long hours in a sitting position with audio equipment on her head, so did not physically move around much. Her breathing was quite shallow and she had even noticed that at times she ran out of breath towards the end of long sentences, as she did as she chatted to me. Jenny told me that she frequently had upset or even abusive people on the other end of the phone, which made her feel very tense. We then went on to talk about why her voice had become disturbed, and the reason for her sense of excess mucus. Work on increased hydration, breath, deconstriction, vocal fold flexibility and postural changes made a great improvement to Jenny’s voice in three sessions. She said that she had become generally more aware of voice and, at her appraisal of one of her taped interviews, her manager had commented on how well the tone of her voice was able to communicate empathy, sympathy and – when necessary – firmness and calm. Jenny said that although she knew that she had always been a good listener her increased vocal confidence gave her more authority and flexibility: ‘I’m not protecting my voice anymore; if I breathe from lower down, and I follow it through, I’ve got the strength there to deal with any caller.’

Group 4: informers • Typically: long periods of uninterrupted strong voiced speaking to varying size groups and in large spaces, as well as to individuals. High level of responsibility for group, with need to be able to use voice to inform, persuade, inspire, etc. • Examples: teachers, aerobics and fitness instructors, lecturers, spiritual directors (rabbis, clergy, mullahs etc.), professional storytellers.

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Teachers and lecturers As we have seen, teachers head the list of workers who appear at voice clinics. Their voices are a core tool of their trade, and have to be strong, clear and reliable, with qualities that appeal to student listening. Research by SLT Jemma Rogerson (Rogerson and Dodd 2005) found that it was more difficult for children to process information given to them by a dysphonic voice than a normal one. This is clearly very important for the teaching voice, and is a wider illustration of the profound effect that voice quality has on listeners’ reception and reaction to a message. It has long been recognised in the business world that a poor oral delivery will lose the attention of listeners, and that voice is an important part of this. Further education colleges and universities have been slower to take this seriously, but some do now offer extra training in relevant voice skills. Hopefully schools will gradually catch up. The VCN (UK) has long promulgated the common-sense view that prevention is better than cure, and that voice training should be part of all teachers’ courses, but this is by no means universal. Actors have intense regular voice training to help them deal with a potential eight shows a week. School teachers have little training and are expected to do five shows a week in term time, with each ‘show’ lasting around 6 hours.

Voice care All practical voice care steps are important for teachers. Adequate hydration is particularly relevant and, although teachers often find that they are not allowed to drink water in front of the students, there are always quick spaces between classes. Even a short training session on voice care can make a significant difference, as shown by Hong Kong researcher Roger Wai Kai Chan (1994). He gave 12 kindergarten teachers a single 90-minute workshop to teach them the basics of voice education and self-help strategies, and the group practised these strategies over 2 months. At the end of this time their voices were reassessed and found to have significant improvement compared with kindergarten teachers who had not had any training.

Voice use Chan’s kindergarten teachers worked with young children against a fairly quiet background noise level of around 35–45 dB, but many teachers deal with a far noisier class. For any teacher with higher vocal demands in terms of background noise, class age or emotional and other stresses, voice care advice needs to be supplemented by high-quality experiential training to extend voice skills. A half-day course can give a useful ‘tune-in’ introduction to basic ideas, but longer is essential in any course that claims to be an effective training in voice skills for teachers. Regular practice is needed to develop permanent change in neuromuscular patterns for more vocal strength and flexibility. Most teachers enjoy feeling and hearing the increased power and variety in their voices and the increased vocal health and confidence that this gives them. Simple ideas can easily be incorporated into a busy day. Clients can do short vocal warm-ups in a car on the way to work, use their own warm

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hand over the waistband as subtle biofeedback reminder to use lower breath, deliberately increase loudness and pitch variety, and use break times to drink water, and to stretch and deconstrict. One client, a busy secondary teacher, regularly shut herself in the walk-in stationery cupboard to do 5 minutes of body and voice work in the mid-morning break! Other professions in the informer group generally need less intense work than teachers, and often seek voice support only if in trouble. The work of professional storytellers mixes informer and performer roles; many develop a ‘natural’ style, but some seek coaching from theatre voice teachers for work on their dramatic use of voice. This can also be relevant for some spiritual leaders.

Spiritual leaders Spiritual leaders vary in the amount of large group speaking, singing or chanting that they need to do, and in how much they use their voices in an artistic way. Although they will undoubtedly do considerable one-to-one work in their ‘supporter’ role, they are also required to speak in large and often echoing spaces. In-house sound systems are increasingly installed in churches, synagogues, temples and mosques, but most spiritual leaders will sometimes find themselves speaking with no amplification even in the open air. Some speakers may benefit from a simple voice warm-up before they have to chant, sing or speak at length. So long as all words are audible, there is no universal style for this group. Times have changed since Spurgeon’s (1856, republished in 1980) classic book, which told Christian clergy ‘when you speak of heaven let your face light up, let your eyes irradiate a heavenly gleam, but when you speak of hell your ordinary face will do’. The book contains some wonderful quotes that I sometimes use for both entertainment and education in working with this group, and some still make excellent sense. In giving a sermon, any spiritual speaker will best serve her message if she has at least some vocal variety in pitch, loudness, pace, pause and emphasis. Spurgeon is eloquent about this: ‘what a pity that a man who from his heart delivers doctrines of undoubted value, in language the most appropriate, should commit ministerial suicide by harping on one string, when the Lord has given him an instrument of many strings to play upon.’ Religions and their subgroups differ, however, and both powerfully dramatic and rather monotone chanted deliveries have their place in religious ceremonies. Very few religious leaders can simulate the exact energy and vocal tones of a typical group address in a one-to one-voice session, so I often suggest that a speaker surreptitiously records one of his addresses, because only in this way can we really hear how he sounds in action.

Group 5: leaders and sellers • Typically: generally shorter periods of uninterrupted speaking than group 4, but an important relevance of body language and voice to influence people; high loudness levels at times. • Examples: business leaders and managers, sales people, managers in institutions, politicians, barristers, judges.

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Voice care The usual practical voice care steps are relevant for this group, but the main focus of work will be on voice use.

Voice use The description of voice use in this group is the longest because the skills required can be quite extensive, and link to the next two chapters. Leaders and sellers do not need the depth and rigour of actor training and may indeed express a fear of ‘sounding too theatrical’, but attention to the performance skills of image, presence, energy and variety can help their own confidence and communicative impact. There are now many companies and voice teachers who offer a range of training topics to these professionals. Voice may be a specific course, or form part of a wider brief such as negotiation skills or personal impact. It is to be celebrated that there is a wide variety of voice and presentation styles and no ideal, so the aim of communication work in the business world is to change any negative aspects and develop the positive. Practical work on body, voice and word can significantly change a listener’s judgement of a speaker from dull and pedantic to energetic and original. The aim of experiential work is not about creating a false image; although a presentational style may need to be a slightly heightened version of ordinary talking, the voice must feel comfortable and true to both speaker and listeners Group discussions with groups over the years has led to the development of Table 28.2, as we analysed what makes a ‘wonderful speaker’ in terms of both impressions and skills. The nine terms are those most commonly offered by leaders and sellers, and core communication skills are identified as contributing to that impression. There is also the important ‘other’ category space for the unexpected and idiosyncratic personal aspect. No training would ever claim to turn all speakers into great orators, but such analysis can give a speaker an understanding that there are practical skills that can be practised and improved. We can then talk about where an individual speaker’s stronger and weaker areas lie, watch him in action and sometimes use a self-rating scale such as Table 28.3. Assessments such as this may be relevant to the 360° appraisal common in many big companies, where an employee is asked to rate himself on various categories, and a senior colleague and a peer also rate his competencies. Such feedback is valuable, and may lead to a decision to set up communication skills training. Ideally we would watch the speaker in a ‘real-life’ presentation or meeting, but this is not always possible. We can ask him to try to film himself in action, and ask politicians and media presenters to send footage or sound recording before the first meeting. If neither real nor filmed material is possible, the voice practitioner will of course watch and listen as the client presents a short talk in the session. As we see, the aspects on the ‘speaking wonderfully’ list are wider than voice. In some speakers their voice may be the most relevant area for work. In these cases I regularly use the Voice Skills Framework scheme. Box 6.3 (p. 86) demonstrates its use with a lecturer, and in Boxes 28.1 and 28.2 its use with a politician.

454 Voice Work: Art and Science in Changing Voices Table 28.2 Speaking wonderfully: impressions and communication skills.

Impression

Communicative skill contribution

1 Personal authority

A good opening and ending Strong posture and body language Central breathing and strong voice Good eye contact Balanced vocal resonance Not too fast a speed and appropriate use of pause Dress sense

2 Receptive

Know your audience Respond to individual listeners Pick up speakers’ own words in questions

3 Knowledgeable and interesting

Know your subject – figures and specific facts Wide and lively vocabulary Variety in voice

4 Articulate

Clear consonants Wide vocabulary Sentences are fluent and succinct Presentation has been rehearsed aloud

5 Confident

Physiological and mental preparation Body, breath and voice control

6 Clear

Good structure and signposts in the presentation Clear articulation of words

7 Enthusiastic and energetic

Variety in voice – pitch, speed, loudness, emphasis and pause Appropriate use of images and vivid vocabulary

8 Gravitas and levity (lightness and weight)

Balanced body posture + slow enough speed Humour + A ‘light in the eyes’ + vocal variety

9 Memorable

All this plus the odd quirky bit and a strong ending!

10 Together with your own particular individual style and strengths

At different times in their working demands, politicians will have roles as supporters, callers, transmitters, informers and performers. Their voices are often mentioned in the press, and criticised if they do not conform to the media’s idea of a good voice. At busy times on the electoral circuits politicians will be using their voices all day, and the long hours, continual new places and people, tiredness, noisy atmospheres and emotional demands can take their toll. For those in government office there is little time for reflection and practice needed for voice work. Unusually, the new Scottish parliament building has many specially designed window seats or ‘pods’, designed for quiet contemplation. There is just room for one person to sit in – to think through decisions, rest the mind or become aware of breathing.

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Table 28.3 Speaking wonderfully: individual ratings. 1 Structural aspects Opening Closing Clarity (the path through the speech) Variety of vocabulary and image Use of audiovisual support

1 1 1 1 1

2 2 2 2 2

3 3 3 3 3

2 Body Posture Movement (stillness vs activity) Breath Facial expression Eye contact

1 1 1 1 1

2 2 2 2 2

3 3 3 3 3

3 Voice variety Pitch variety Speed variety Loudness variety Stress/Emphasis Pause Resonance quality

1 1 1 1 1 1

2 2 2 2 2 2

3 3 3 3 3 3

4 Feeling aspects Attention to audience (preparation, receptivity and fluid response) Confidence (how you come across) Levity (lightness of touch, flexibility and humour) Gravitas (authority and stability) Energy and interest

1 1 1 1 1

2 2 2 2 2

3 3 3 3 3

5 Other 1 = weaker; 2 = adequate; 3 = strong.

Voice story: politician Andy was a 34-year-old politician with little time or space to reflect on his voice but high motivation to get some independent feedback and follow a structured programme of work. He was doing well in his career, and happy with his voice in his private meetings with constituents. However, he was concerned about a lack of ‘oomph’ in his style in meetings and presentations. A colleague once told him that he did not always come across as energetic, though his talks were fluent and knowledgeable. He felt that this might be connected with his voice, which he described as ‘boring and droning on’, and wanted to know how he could come across as passionate and interested as he truly felt. He was keen to actually see results, so we decided to use the Voice Skills Framework to show what changes might happen. Boxes 28.1 and 28.2 show how he changed over a period of 9 months.

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Box 28.1 Andy’s Voice Skills Framework at first meeting 1 Body Tendency to stand very stiffly and hands behind back when presenting, with facial expression in ‘earnest’ mode. No particular excess tension in these muscles but A says he often feels very tight in this area after a long days’ work or before major presentation. Sensation of tightness and dryness if ever nervous. Describes himself as easygoing and rarely very uptight, so long as no particular crisis! 2 Breath Upper chest, but adequate for speaking. Breath control fine. 3 Channel Appearance of ‘stiff upper lip’ and limited range of lip movement, contributes to his rather ‘dead-pan’ facial expression. Close jaw setting, minimised range of movement and an impression of clenched jaw. Scottish accent – Perthshire. Forward placing, lively tongue movement. Slight pharyngeal constriction, but not abnormal or unpleasant quality. No laryngeal constriction/strain in habitual voice but occasionally slight in the raising voice task. 4 Phonation Slightly rough and creaky, but well within normal limits, and actually quite ‘interesting’ quality. Says he feels that his voice is sometimes tired after long day talking, but his days are very long. 5 Resonance Excess head resonant quality – could do with more ‘warmth’ of chest resonance; impression of slightly ‘whining’ tone – probably what he hears as ‘thin’. Can feel ‘lip tickle’ sensation – voice sounds forward placed. 6 Pitch Centre low mean – no problem Limited range of high and low variations in presenting speech – slightly monotonous. Glide is fine. Tends to have odd rather repetitive falling line at end of sentences. Says he lived in Northern Ireland for 3 years in early teens. 7 Loudness Somewhat low average loudness level. Little loudness variety in either conversational or presentation contexts. Not enough use of word or key point emphasis, given the importance and specificity of some of the information he has to give in presentations. Slight ‘push’ when raises loudness level – impression of not using enough breath to ‘play’ the voice in terms of energy variety. 8 Articulation Consonants crisp and clear. Vowels tend to be ‘smothered’ by tight jaw. Very fast and little variation Very few pauses in conversation or presenting. Occasionally slightly ‘jerky’ delivery – when nervous or thinking on feet.

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Box 28.2 Andy’s Voice Skills Framework at last meeting 1 Body Much improved – a real sense of movement and energy now – more willing to smile and generally a ‘lighter’ feeling to his whole presentation. A says does not feel tight after talking now, as is more confident and physically less tense. Reports he still has occasional sensation of tightness/dryness if ever nervous, but generally tells me he is less often nervous now. 2 Breath Still fine. 3 Channel Increased range of movement and facial energy generally. Jaw better, in that less close and more range of movement, but could open up further! Only slight and occasional pharyngeal constriction – much less apparent as ‘throat’ sounds more open. Still slight tendency to tighten when raises volume to high level but within normal range and only slight laryngeal constriction in speaking – work not essential but could be protective. 4 Phonation Says less aware of vocal fatigue after long talking. 5 Resonance Much better, resonance sounds more balanced with chest resonance opened up. I have suggested further work on his own. 6 Pitch Markedly wider range –reported that occasionally in practice after work, went too far and felt he sounded slightly manic! Now settled to a natural sounding and lively wider range. Still quite frequent ‘falling lines’, but not a problem now as much more intonation variety. This definitely contributes to increased impression of energy. 7 Loudness Overall higher loudness level with better impression of power. Much improved variety of loudness, which has greatly improved energy and interest in A’s presentations. Now marks key facts if uses script, to make sure that he gives them enough emphasis. Still slight impression of ‘push’ but improved – we have discussed A doing further work to further improve breath/sound energy coordination. 8 Articulation Vowels sound ‘fuller’ as jaw freer. Pace better – slower and more variety – but still ‘rushes away with himself ‘at times – will try to stay aware of this tendency. Improved, but still needs to trust that he allow more use of pause to allow particularly dense financial facts and figures to be ‘digested’ by listeners. Smoother rhythm – more confident.

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My summary notes for my first session with Andy are as follows: • Voice gives little impression of warmth or energy. • Nice humorous energy when chatting to me – need to bring that into the more formal presentations that he is increasingly having to do. • Says he was very shy at school – and that he sometimes feels that he is ‘conning’ everyone who has become successful comparatively young. • Wide vocabulary and occasional vivid image in expression – gives impression of fluent intelligence – just rather dull delivery of message. The action plan notes included: • Body work to ‘loosen Andy up’ in terms of the physical energy that he both feels and conveys as he talks, focusing on standing posture as he wants to use this position. Work on posture for stronger presence impression. • Use both mirror and DVD to explore new options. • Use this with facial expressions – work on the image of ‘light behind the eyes’. • Water intake may be relevant for general hydration levels – check? • Lip and jaw work – and ‘throat release’ work – as part of work to open up the chest resonance, to help give impression of warmth and authority. • Pitch range and variety work – tune him in to the falling line, and explore options. • Volume variety work – introduce idea of that as being able to ‘play the energy ‘ • Practise pause. Practise emphasis. Work on speed variety. After training, Andy said: ‘I have had an opportunity to practise my impact in a variety of contexts and all have gone well. The sessions have been really helpful in changing the pace and energy in my public talks and meetings. I’ve actually felt more energetic, and feedback has been great. I’ve also enjoyed my new and deeper chest sound – very manly! Altogether I feel and sound much stronger and more varied.’ As with any speaker, the need to ‘find your own voice’ can reach deep into the psyche of anyone in this group.

Voice story: business manager Zanna was a senior manager and joined the first of three training days that I was running for a large company. She was concerned about criticism that, although her work was good, she did not contribute enough during monthly planning meetings. Even when she did offer ideas, she told me that she could not make herself sound strong enough to be ‘properly respected’ by the other eight managers – seven of whom were men. In the morning we did a series of physical and breath exercises followed by a full loudness calling game on hey! This developed into an entertaining impromptu improvisation as the group members sang a description of their working lives in operatic style. Zanna relaxed into the sound and produced a loud full-bodied voice that surprised and amused everybody – including herself. In the next exercise participants were asked to

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work in threes: two people had to talk about a topic of interest and to ignore the third who was told to try to come in on the conversation. Zanna found this interruption task very difficult; her voice returned to a quiet, slightly high-pitched, strained tone and, after a while, she gave up. I could see that she found the exercise upsetting. I made time to talk privately to her at the lunch break. Here she told me that she had been the very shy and quiet youngest of five children, and all her older siblings had been strong and loud characters. Some youngest children become very assertive but others retreat into a sense that they have no right to speak. We talked about how, even though Zanna had become successful in her work, meetings might be mirroring her original family matrix, and she unconsciously froze in those settings. She had not considered a family–work connection before and even the insight helped her to handle things better. She worked on the deep breathing exercises that she had learnt in the training day, and these allowed her to feel calmer when under stress in meetings and to access her own inner strength. In the next training day we worked further on freeing the voice and she worked hard. She also decided to sing and call loudly when walking her dogs in Richmond Park and began to enjoy the sound of her own big voice. Over the next 3 months her ability to speak confidently at team meetings developed until she was a vociferous and positive contributor to the group.

Body language If voice is the background music to our words, body language might be considered the theatre set of spoken communication. It is an important part of general communication skills and voice practitioners may also be involved in training in this area. Hargie (1997) provides a thorough introduction to this area. Sensitivity to a speaker’s body language is relevant when we are working closely in training or therapy because it can help us to interpret what people are really feeling or meaning. For public speakers, inappropriate dress, a strange facial expression or gesture, or too close a proximity to another person can sabotage even the most persuasive of spoken arguments. Specific work on these areas may be part of training if a worker is going to work in another country with a different culture, because these can have significant differences. Dalrymple (2003) writes: ‘Muslim chroniclers . . . singled out Mir Alam’s ferasat, which is sometimes translated as intuition but which has far greater resonance in the Persian. It refers to that highly developed sensitivity to body language that almost amounts to mind reading, and was regarded as an essential quality for a Muslim courtier. It is still an admired feature in the social and political life of the Muslim East.’ Body language awareness is invariably part of cross-cultural familiarisation training in the business world. As part of work in this field, I was asked to go to India to research the subtle differences in the ways that Indian and British business people in the software industry communicated at work. One result was the development of a simple ‘Indo-British Cultural Communication Inventory’, which described the differences under the main headings of speech skills, body language, communication skills and attitudinal issues (Shewell 2000a). One small example illustrates how misunderstandings can happen between cultures. Many

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Indians use a graceful head tilting-and-rocking movement, which looks a bit like a head shake; Kolanad (1994) describes it ‘as if the Indians have an extra bone in their necks which allows the head to glide in a sinuous back and forth and up and down at the same time movement, as smoothly as if it rested on ball bearings’. It is not part of western body language, and is often interpreted as a negative by a British listener, but its meaning is different and more subtle. It means something along the lines of ‘I hear and appreciate what you are saying, and I may – or may not – agree’.

Group 6: performers The two main professions in this group are described in Chapters 29 and 30. This separation reflects their particular high-level vocal skills and demands, and the fact that they are the main focus of the voice teaching and singing teaching workforce. Performers must be in full control of an expressive, reliable vocal instrument, because the quality of their success will be directly related to their quality of voice. ‘We emphasise the problems of professional actors, and especially singers, because they are the Olympic athletes of the voice world. Their extreme anatomic, physiologic and therapeutic demands tax our clinical and research skills: but what we learn from them is applicable to all patients’ (Sataloff 1997).

Postscript: voice work with disempowered individuals This chapter has looked at the relevance of voice and communication to those at work. Voice work can be highly relevant for those who are not in work, whose voices are not heard in the society in which they live. Their background and living conditions may have denied them a basic confidence and facility in the complex communication skills needed for the manoeuvres of a highly verbal mainstream society. Voice practitioners work on communicative sound and, with the right skills, sensitivity and knowledge, they have much to offer in this field. Voice teachers may work with prisoners, refugees, asylum seekers and others whose current situation blocks their voices. SLTs may train communication skills in work with clients with a learning disability or mental health problem. Singing teachers know that the singing voice can cross and form bridges across boundaries, and some run transformative workshops with those who are disempowered and excluded.

Recommended books Berry C. (1994). Your Voice and How to Use It, revised edn. London: Virgin. Boone D.R. (1991). Is your Voice Telling on You? San Diego, CA: Singular. Martin S. and Darnley L. (1996). The Teaching Voice. London: Whurr. Rodenburg P. (2007). Presence. London: Penguin.

Chapter 29

The acting voice

‘Pray God, your voice, like a piece of uncurrent gold, be not cracked within the ring.’ (Hamlet to The Players Act 2, Scene 2, Hamlet by Shakespeare)

A voice teacher colleague once said that, if we can teach voice to actors, spoken voice work with others is ‘a cinch’. Well, yes and no! It is true that the voice skills needed for acting can be modified for work with other professions, but many professional voice users see the actor’s voice as more energetic and noticeable than how they would want to sound. In fact an actor’s ordinary spoken sound should not stand out as ‘over the top’ in any aspect. Its flexibility, resonance and confidence may, however, sound different if surrounded by cramped or distorted voices, but no quality should be excessive. Nowadays much acting work demands that an actor has a voice that does not sound different to the ordinary man or woman in the street. Sometimes the voice needed for a character is required to be ‘dysfunctional’ or excessive, and a voice teacher may have to help an actor survive its use in a nightly naturalistic play or television ‘soap’.

The actor’s life Actors are sometimes mocked with the derogatory term ‘luvvies’, with its implication that they are indulgent melodramatic speakers whose skills are not far removed from what anyone could do. This view undervalues the depth of most actors’ training and skills, the commitment to their craft, the intensity of their preparation and work, and the relevance of their work to our own lives. Watching, hearing and feeling an enacted story unfold offers the viewer an experience of others that he would not otherwise have, and can at times be transformative. All over the world, the ability to ‘project’ into imaginary characters is part of the lives of the millions who engage with television dramas, and a rich strand for those who visit theatres and cinemas. As such it is a central aspect of the artistic and psychological energy of most countries. While director of the Royal National Theatre, Richard Eyre (1996) wrote: ‘the arts tell us truths about ourselves and our feelings and our society that

Voice Work: Art and Science in Changing Voices. Christina Shewell © 2009 Christina Shewell. ISBN: 978-0-470-01992-4

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reach parts of us that politics and journalism don’t. The arts, above all, help us to make sense of the world; they help us to fit the disparate pieces together; to try to make form out of chaos.’ The rhythm of the working actor’s life is sometimes like a travelling circus; the show happens with all its colour and intensity, and then next morning the circus has moved on. The actor often finishes one job with no idea of when she might work again. Student actors dream of enriching roles and success, yet, at any one time, large numbers are out of work. A major survey of those employed in the performing arts in the UK (8337 responses) showed that 71% spent more time working outside the performance industry than within it. Half of all those working earned less than £6000 in the last year. Only 6% earned £30 000 or more, and men were more likely than women to have earned that sum. Nearly half (47%) of those who responded said that they had training or development needs at the time of the survey, and voice/accent coaching and singing lessons were two of the seven most commonly recognised needs (Skillset 2005). Equity, the British actors’ union, represents actors and many singers. In early 2007, the Equity minimum for actors working in a small-scale theatre was £350.00 per week. For eight shows (six evenings and two matinees) a week, at 4 hours in the theatre for each show, this worked out at £12.50 an hour, a small and hardly glamorous fee. Even successful actors rarely rest securely upon their laurels, for as the poet Emily Dickinson wrote: Fame is a bee. It has a song – It has a sting – Ah, too, it has a wing.

There is huge variation in acting work. Theatre, television, film, radio, ‘talking books’, voice-over work, stand-up comedy, musical theatre, poetry and prose readings, and the use of dialects all make particular demands on the performer’s voice. The needs of radio and television broadcasters have something in common with the actor, in that they are required to confidently, reliably and fluently communicate written words to a mass audience. Both have to ‘lift the words off the page’ and make them sound real. Broadcasters and documentary narrators may sound dull in their reading and need practical voice work to make their scripts come to life. Although not playing a character, the broadcaster may be speaking about a wide spectrum of emotional issues. One experienced radio journalist told me: ‘I play the role of a larger than life version of me, always calm and in control. But sometimes reading the news is distressing. I have to speak as if I were completely equable, and not let it choke me up.’

Voice training for student actors Voice teachers work with both amateur and professional actors. Some of the latter group will have followed a formal training course, but many do not. There is less experiential voice work in university theatre studies than in drama college courses, where students may have several spoken voice and singing classes a week. This will include technical, imaginative and text work to develop the power and sensitivity of the voice, and development and feedback related to specific roles in stage and screen drama. The actor has to be

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a chameleon with a solid core of skills and an ability to adapt to any demand of the text or part. Movement and voice are the vehicles of meaning in acting. Voice teachers agree that bodywork is a foundation for voice development. Grotowski (1975) wrote ‘imprint upon your memory, the body must work first. Afterwards comes the voice’. Berry (1987) said ‘we need to make sure that our body is in good alignment . . . yet ready for action’. McAllion (1988) described how ‘most people actively interfere with the way their voices should work, and that interference begins with the way they use their body as a whole’. Rodenburg (1992) writes ‘proper voice work is very physical. It involves the use of the whole body’. Lessac (1997) says ‘in Lessac training it has become a “given” that vital (organic) voice training should always be preceded by integrated body training’. Houseman (2002) writes ‘working on the body . . . is the quickest way of working on the voice’. Linklater (2006) writes ‘physical awareness and relaxation are the first steps in the work to be done on the voice’. In her website, Fitzmaurice (www.fitzmauricevoice.com accessed in 2006) describes her emphasis on ‘physicality: we develop awareness of patterns of vocal effort through a series of gentle and/or rigorous exercises, accessing the body’s own healing systems for deep release’. Students will work to develop technical aspects of all the voice skills, and will also learn how to acquire regional dialects (the term used for what phoneticians would generally call accent). Acting courses never now demand that an actor lose his original home accent, but, in British drama courses, all students are expected to master standard English – the general term for received pronunciation (RP). Singing teachers have a significant input to the curriculum of actor training. Although many professional actors avoid singing roles, some become hugely accomplished and successful in musical theatre if they have a good voice and musicality. The actor-singer often has a particular ability to communicate the meaning and emotion of song words. Indeed, when singers work first on the spoken communication of the words of the song, the quality of interpretation is likely to be greatly enriched. Actors may seek the support of a top singing teacher when a role makes this necessary; these may be self-funded or financed by the company. Acting training aims to give the young actor physical and vocal skills that become organic to seamlessly connect to text, character and dialogue, through any performance demands. ‘The very highest manifestations of any art are always characterized by a technique so flawless that it is unnoticeable and becomes one with the art itself’ (Turner 2000).

Research into voice training for actors Voice work in the theatre world is still almost entirely experiential and performance based, and the effectiveness of Turner’s ‘flawless technique’ is usually monitored and judged by eyes, ears and experience – rather than scientific analysis. Nothing can ever substitute for these ‘three Es’, but objective evaluation is an increasingly frequent requirement of many arts training institutions, and technology is an essential part of this. Although ‘few studies have been performed regarding the acting voice’ (Emerich et al 2005) and ‘scientific research on the training effect is rare’ (Timmermans et al 2005a), some studies provide interesting findings.

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Feudo et al (1992) investigated whether acoustic measures could find changes in student actors’ developing voices. They tested a number of voice parameters over a 2-year period and found that nine voice aspects showed significant changes. These included the students’ competence in maximum exhalation and phonation times, pitch range and loudness levels, and they also developed the important skill of changing loudness without simultaneously changing pitch. It is interesting to see that in the first assessments students used a higher pitch mean and wider pitch range in dramatic scripts than in prose reading – quite possibly a ‘trying too hard to be lively’ pattern. By the end of the assessments they were using less extended pitch range and lower pitch mean in the performing tasks, i.e. more naturalistic. Laukkanen et al (2004) set up computer visual feedback for students working on certain aspects of their voices. They concluded that this appeared to ‘add some efficacy in voice training but there is some danger of hyperfunctional voice production if other sensory feedback is neglected’. We may strain our voices if we focus so much on ‘screen watching’ that we neglect to attend to the sensations of hearing and feeling our sounds – a reiteration of the need for multisensory experience in learning. Timmermans et al (2005a) looked at the effects of voice lectures and practical training on the voices of 23 Belgian students over an 18-month course. One important finding clearly showed that, although the students learnt enough voice care theory to pass an exam, they did not necessarily put this knowledge into practice, and so many still experienced voice problems. This again points out the need to do, not simply to acquire information. Pinczower and Oates (2005) looked at the nature of voice projection. Working with 13 trained and experienced male actors, they investigated the difference between ‘comfortable acting voice’ (small audience in small room) and voicing with the strongest possible projection (as in a large theatre). Their research found acoustic and perceptual differences between the two vocal styles and, in the large theatre, actors used ‘increased acoustic energy in the higher part of the spectrum’. This offers support for the idea that trained speakers may learn to use a kind of ‘speaker’s formant’ – a particular resonance quality – to help the voice carry. Emerich et al (2005) explored whether actors stayed within ‘safe’ pitch and loudness areas or went towards the limits of intensity and frequency when performing a speech from Arthur Miller’s A View From the Bridge in both a studio/laboratory and on a professional theatre stage. The eight actors first completed a formal voice test, using an acoustic Voice Range Profile (also called a phonetogram). This assesses the highest and lowest pitches that can competently and comfortably be made at loud and soft volume, and the patterns in between. It can give an idea of a singer or speaker’s capacity and skills in areas of pitch and loudness. When they spoke the emotional dramatic text, the authors found that all the actors ‘exceeded their physiologic VRP baselines in one aspect or other during the performances in either the studio lab or the stage’. In the formal VRP assessment the actors had ‘stayed safe’ in a task that has no emotional content compared with a dramatic speech in character. It will not surprise voice teachers that here the actors’ habitual speaking voice ranges were found to be significantly smaller than their full available range: ‘With emotional content and connected speech, actors could surpass what they could produce on a single tone.’ As we know, emotion and performance on stage in front of an audience stretch many boundaries; actors may regularly need to sustain levels of voice intensity that verge on ‘vocal violence’ and need good protective skills.

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Voice work with professional actors Vocal development continues throughout an acting career, and many successful actors continue to work on their voices. ‘In order for text and acting work to grow and remain linked to the voice, work in these three key areas has to be constantly maintained throughout an actor’s career’ (Rodenburg 1997). Moving from screen to theatre can be particularly challenging; there is the practical demand for vocal stamina, and even famous actors often feel the public’s demand to prove that their acting skills are real and not an artefact of the camera. When Jeremy Irons moved from a series of film roles into playing Leontes in A Winter’s Tale he said in a radio interview that he recognised that he did not have the vocal power and range to cope with the demanding text, and he had to work hard to avoid putting strain on his throat. Alongside the technical work, the voice teacher plays an important part in helping the actor access a sense that a character’s language and voice are coming through him, so he speaks the words as if discovering what he thinks or feels. It is impressed on all voice teachers that they should never give an actor ‘a line reading’, i.e. tell the actor to copy our speaking of a line, or dictate how it should be spoken. The task is to choose the right exercises to facilitate the actor in finding and using the voice that connects to that text and character. If a specific accent/dialect is also needed for a show or a character, the voice teacher will teach this using tools that include sound recordings of that accent, and detailed analysis of its individual speech sounds, typical vocal tract settings, rhythm and intonation patterns. The most successful dialect coaches specialise in that field, and you can see their names in the credits of many films. The voice teacher has to be able to sit and listen to an actor speaking a sonnet, dramatic text or film script and say ‘mmm – something not working here – what is it?’. It may be a specific technical issue of voice or dialect, but it may also be something less immediately tangible – the quality of authenticity or spontaneity, the complexities of emotional intent, the relationship to another character or the communication with the audience. An illustration is seen in the description of a master class given by the head of voice at RADA, Ellen Newman. ‘What struck me was Ellen’s ability to work through artistic, imaginative means which enabled the actor to find for herself a voice that not only expressed the text with a high degree of understanding and emotional connection, but was also technically efficient. Through her suggestions, questions and in-depth analysis of text, the actor moved away from a pushed and chesty sound to a released, varied and vibrant delivery that was more enjoyable for her to perform and us to listen to’ (Parke 2005). In the UK, the first full time permanent voice teacher at a theatre company was Cicely Berry, who joined the Royal Shakespeare Company (RSC) in 1970 and has been an inspiration for many actors and voice teachers. Few theatre companies have regular voice staff; most employ voice teachers on an ad hoc basis, as and when the director feels that this would be a good idea and finances allow. There are different options: voice work for accent acquisition may start before formal rehearsals, some directors work with a voice teacher so voice is an integral part of a show’s development, and others expect voice work to happen quite separate to the rehearsal space. A voice teacher should be involved early on in the rehearsal process.

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Voice story: Sarah The morning before the press night of an intense modern play, a theatre telephoned me with a request that I see the young female lead, who was described as ‘not loud enough’. Sarah came that afternoon and was naturally outraged that the director was only now suggesting voice work. He had said nothing during the 3-week rehearsal period; she had deliberately played ‘small’ as she felt that this voice was right for her character – an insecure young woman. Her training had been based in physical theatre and she had little technical knowledge of how to project her voice. As the compulsory last-minute voice teacher, I sensed that some of Sarah’s anger was projected onto me and decided to work with this, to discharge its negativity and to use that energy to find a different kind of power for her voice. We did some vigorous body movements and I encouraged her to let some sound out to express how she felt. This led into some strong centred voice work; I wanted her to access the ‘huge’ loud voice that she did not want for her character. We then calmed emotions, body and voice down, and found a quieter but solidly based vocal power. I did not want to work on Sarah’s actual lines, so we used other dramatic text to explore forward oral resonance and speech sound clarity. She was pleased to find a strong but not forced voice, and we agreed to meet next morning on the theatre stage. Here we did some warm-up work on three main areas: 1. Tongue movement work, as Sarah’s habitual tongue setting in ordinary speech was backed with rather minimised movement. 2. ‘Over-talk’ in fast reading and speech to mobilise lips and jaw and forward resonance. 3. Relishing the words – using an exercise where she read one word of a dramatic line, then two words, then three and so on, as the sound and meaning of the sentence developed. I then moved around the empty auditorium so Sarah could use the new technical skills to send her voice to different places, and only then picked her up on any key words that ‘dropped’ in energy too much. Both Sarah and the director were pleased with her sound on opening night. We met 3 days later to consolidate and develop the work done, and I strongly suggested that she fix up some regular voice lessons before accepting another stage role. I also wrote to the theatre to ask that in future voice work should be considered far earlier than the night before opening. In this case, voice work was effective for both actor and production; if an actor needs and does not get voice support during a production, he may arrive as an ‘emergency’ at the voice clinic, and it is then that the voice team need to work together to support the actor in whatever way is possible.

Voice disorders and the actor Anything that affects the quality, power, stamina and creative range of the voice threatens the performer. Actors can develop any of the voice disorders described in Chapter 27, and

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may need medical treatment and voice therapy. They may sometimes need extra medication; in appropriate cases, laryngologists occasionally prescribe an emergency dose of oral steroids to help shrink vocal fold swelling in an actor or singer who has to perform. All voice practitioners should have the contact of a good ear, nose and throat specialist. Although many actors are financially stretched, I advise clients to keep the contact details of a private laryngologist who can see them quickly, and will ideally have special expertise with performers. Katharine Hepburn (1991) wrote: ‘I went to a theatrical doctor. They are the only ones who realise that you absolutely have to go on no matter what if you’re an actor – or die on stage.’ Clinical literature quite naturally and correctly advises some period of vocal rest for any performer with a diagnosed voice disorder. Although classical singers with voice problems will usually be unable to fulfil their vocal demands, actors will often try to keep working if their voices can work well enough for the performance. Of course they should take time off and not use strong voice on stage for eight shows a week with a voice problem, but many feel that they cannot do this. The stage show has an unrelenting continuity, and small professional shows and amateur theatre rarely have understudies. Actors anyway hate to have their stand-ins perform in their place. Short TV and film takes may be managed with support from rest, medication and water, and filming schedules can sometimes be rearranged to allow recovery time, but not always. There is certainly a sense that ‘the show must go on’ but there is also a fear of damage to reputation. Performers usually keep a voice disorder diagnosis secret, in case ‘the business’ sees them as having a permanent vocal weakness. This can be particularly true of vocal nodules, the onset of which is still dreaded in the performing world as a sword of Damocles. This is ironic, because vocal nodules are usually a nuisance not a disaster, and can offer an important opportunity for beneficial change. The actor who recovers from vocal nodules after a course of good voice therapy is likely to have a healthier and more resilient voice production than those who manage to get away with bad vocal habits for years (Shewell 1995). Speech and language therapists generally work only with actors in trouble and may feel that these clients already know much about spoken voice. But the work of mending damaged voices is different to the aesthetic development of voice. Specific voice development work on text or character aims to enable the speaker to feel less like himself and more like someone else. Voice is in service to text and character. Teacher Andrew Wade said ‘the voice teacher’s job is to instil new life into the spoken word. Letting go of one’s own ego is the first step to finding the ego of the text’ (British Voice Association Conference 1996). Vocal remediation aims to help the speaker feel more like himself, by restoring the healthiest voice possible to reflect his true self. Actors in vocal trouble may know little about vocal anatomy, voice disorders or how to heal a damaged voice. The SLT has much to offer in terms of exploration and action.

Exploration Actors’ voices work long and hard. They may need to perform multiple film takes of a short scene of marital screaming on a cold morning half-way up a mountain, play Hamlet for eight shows a week in a hot stuffy theatre, make repeated recordings in a high squeaky

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cartoon voice to advertise a breakfast cereal, provide the voice of an ogre for a computer game or voice as they dance and sing eight shows a week. As well as exploring the usual health, emotional and practical areas, the therapist should find out about the following: 1. The demands of the job. This might include: how much talking is involved and of what nature any particular physical requirements in the show (e.g. a need to roller skate while acting) any effects of the set design or costumes relationships with other members of the company or crew the size and acoustics of the theatre space background noises and sound effects lighting: voice teacher Yvonne Morley comments that in dim lighting an audience can often think that they cannot easily hear voices (personal communication, 2008) the show rehearsal or filming schedule whether the actor has amplification whether there is need to sing in the show the nature of the audience dates of future vocal demands, e.g. auditions or new roles. 2. The nature of the actor’s training. Relevant issues might include: how long ago this was where it took place and how intensive it was with regard to voice whether he has had recent voice classes whether he has had singing training. 3. How the actor uses his body and voice in ordinary life. Physical fitness, general body and voice care issues are relevant here, of the kind outlined in Chapters 16 and 17. It is also highly relevant how an actor uses his voice in ordinary life, e.g. if actors habitually use lower breath support in real-life conversation, that healthy pattern is then immediately available for any heightened language or vocal demand. Rodenburg (1997) says: ‘if you don’t use support in your daily speaking, you will find yourself always putting on a voice when you act.’ We are more likely to believe in the reality of the acted spoken thought if the words sound as if they are organically linked to a natural breath. ‘For actors, modifying the specific manner of breathing may be the single most practical means of entry into an emotional state’ (Dal Vera 2001).

Action steps An explanation of the problem, with reassurance Actors usually appreciate a full explanation and the chance to ask questions. There is often an intense need for any reassurance possible – he can be helped to stay in the show, the voice will recover, he will be able to work again and his career is not at an end. If any of this news is bad, he will need support to manage the results. If a medical specialist feels that an actor’s intense attention to the minutiae of his voice verges on the obsessional, he should bear in mind that this will be a survival strategy to help the actor feel more in control

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of a threatening situation. Speech and language therapy support may involve liaison with agent or company manager. Here the practitioner needs to support the actor but may need to use careful but honest diplomacy, as when management asks whether an actor’s voice can cope with all the week’s shows.

General care of the voice strategies Therapists should consider having a specific information sheet for actors and singers, such as the example included in Chapter 16. ‘An acting programme without training in keeping voice healthy by protection/production seems to lack a crucial part of the education of actors’ (Emerich et al 2005). Even those who have had that training will benefit from clear reminders. A specialised voice care handout can reassure an actor that his particular needs are recognised in the sometimes daunting atmosphere of a hospital clinic. Personalised suggestions can be added, specific to a particular actor’s current role; below you see examples from my own practice: • To a pantomime stage actor with muscle tension dysphonia: ‘between the Thursday and Saturday matinees and the evening shows, use the steam inhaler and let go for 15 minutes in the semi-supine position on your dressing room floor.’ • To an actor recovering from a vocal fold haemorrhage and about to start filming in Alaskan snow: ‘keep a scarf over your nose and mouth so that you can breathe warmer air until a few minutes before the take, and then do some quiet up and down glides to warm up your voice before speaking.’ • To a radio actor with vocal fold swelling and signs of vocal misuse: ‘at appropriate moments during the recording try to stand up, stretch and do some of those simple physical loosen-up exercises, and maybe in the privacy of the bathroom, do some open yawn–sighs and pitch glides to release any throat tension that’s built up.’ Specific support will be needed for the actor who insists on working through a voice problem, with advice on how to compensate and survive without damage.

A range of voice therapy exercises A range of voice therapy exercises from the clinician’s repertoire will be relevant to both the actor’s ordinary life and his performing demands. SLTs also have the option to use software training packages to give visual feedback about specific aspects of voice use, and performers often find these fascinating. Voice and singing teachers may already be working with an actor who develops a voice disorder. It is ideal if the therapist can work in collaboration, as the story at the end of the chapter illustrates. All practitioners need to remember that many actors in vocal trouble need to stop and release, rather than layer active exercise on top of an already ‘stretched to the limit’ voice musculature. No energetic voice exercises should be given if there is any likelihood of a vocal fold structural problem such as polyps, nodules, cysts, haemorrhage or other pathology.

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Illustration of practical work with an actor with ‘voice strain’ Voice and singing teachers may encounter an actor who complains of ‘voice strain’. This may need ENT examination to rule out a serious problem. However, it may be a temporary reaction to the after-effects of a cold, to a new role with high vocal load of songs or regional dialect, to a performing space with poor acoustic or to difficulties with a demanding director.

Voice story: Colin Colin was a 26-year-old actor who had received excellent voice training. However, while playing Petruchio in The Taming of the Shrew at a regional theatre, he found that he could not access the strength, energy and quality that he wanted for the character. He recognised that he was ‘pushing’ his voice, and regularly felt a sense of vocal strain after a long rehearsal, but did not how to change this. Colin did not want an ENT examination, because he said that he had no problems with his voice except after rehearsals. I was asked to see him in my voice teacher role, but would have suggested a referral had I been concerned. The ideas outlined in note form are used to illustrate how the eight core headings might be used to organise thinking about what might be done in Colin’s case. Although a few exercises use lines from the play, there is little direct work on the text at first; the idea is to extend Colin’s voice skills so that they will then work naturally as he returns to his character. You will see that the ideas come from both technical and imaginative stables, typical of a voice approach in working with a stage actor: 1. Body: • Practical voice care strategies. • Release work in stillness and/or action. • Find Petruchio’s walking rhythm and the breath that goes with that – speaking lines from the play while moving around the room. 2. Breath: • Intensive lower breath work – in both placing and control. Check that he has good support in ordinary spoken voice. • Using long sentences to build up Colin’s flow of breath with voice. • Breathing in some of Petruchio’s lines in silence, and then quietly speaking them out – repeating the same line several times until breath–voice coordination feels quite natural. • Practical voice work on the stage to ‘breathe in’ the space, and focus the voice. 3. Channel: • Jaw release – throughout Colin’s ordinary day. • Laryngeal deconstriction exercises. • Babbling and gibberish to loosen up the sound flow. • Chanting and singing a few lines of the text at high loudness level – discovering how not to ‘clench’ laryngeal muscles.

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4. Phonation: • Colin has no excess rough, breathy or creak qualities; use gentle whimpering sounds to thin the folds and release any tendency to ‘press and bunch’ the folds when pushed. • Coordinate breath and balanced voice onset. 5. Resonance: • Explore contrast of head and chest resonant qualities – let Colin discover any differences in carrying power, and see what might work for Petruchio. • Fee Fie Foe Fum exercise – feel sense of ‘echoing power’ – without push. 6. Pitch: • Good pitch range – no work needed. 7. Loudness: • Focus on all the ideas relevant to projection, but also look at Petruchio’s loudness, i.e. much variety or very little? 8. Articulation: • Listen to Colin in show, and note energy he uses in the speech sounds – he may need to hit the consonants a bit harder to increase sense of Petruchio’s energy and strength. This will help prevent a push at laryngeal level and the dropping of energy towards the ends of sentences.

Rosemary’s story: vocal nodules This story describes a three-way collaboration in voice restoration of an actor, voice teachers and therapist. Rosemary’s account eloquently describes how vocal problems may feel, and it gives insights into her experience of college voice training and voice therapy. It also demonstrates that it can take time and tenacity to fully find the free voice. Even as a student Rosemary had a tendency to throat and voice problems, but these became worse once she began work as a professional actor. Two years after her training as an actor with the Royal Shakespeare Company (RSC), she was told that she had soft vocal nodules.

Actor and voice teacher interview: 3 months after diagnosis of ‘soft nodules’ (I am grateful to Andrew Wade, then head of voice at the RSC, for permission to include this edited transcription of his talk with Rosemary.)

Could you talk a little about when you noticed your voice wasn’t working? I first found my voice wasn’t working when I was at drama school. Even by the fourth or fifth day of a show my voice would be quite noticeably under par, but it didn’t matter because, as a student, you do 4 days and then you’ve got a break and it just gets better. In voice classes I would find that my breathing wasn’t as good as other people’s, which used

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to frustrate me. I joined this company and at first it was fine because I wasn’t doing a lot in shows. It wasn’t a big problem except if I was tired. But this year I’ve had to do a lot vocally, and it began to feel like it’s in the throat, because I was just losing my voice all the time. It’s frustrating because it’s the first time I’m doing something substantial, and I haven’t been up to what I can do.

How did you feel when your voice got worse? Emotionally it’s so frightening. This is the tool of my trade. My body and my voice – that’s how I make my living. It’s like a front-line offensive. It’s terribly upsetting, because you think: ‘I can’t do anything about this, it’s beyond my control.’ Whereas acting is something in your control. I mean, I can get better or worse but it’s up to me. I kept on thinking: ‘But I’ve been really good this week, I haven’t done that much. Why has it gone?’ I couldn’t understand it, and it’s like beating your head against a brick wall. I’d wake up each morning, and for a moment, I’d think ‘I’m OK’. Then I’d speak and realise it had gone. It’s just awful, and you become very upset about it, and that actually exacerbates the problem because your shoulders and your throat tighten up.

How did you feel when you had that laryngology examination 3 months ago? It was actually quite exciting to have my vocal cords filmed. It was an odd experience to have something shoved down your throat and then see an inside part of you working, something that you are not aware of. But the word ‘nodules’ was terribly frightening because it’s something you talk about at drama school. Our voice teacher did warn us, but I didn’t really understand it. We did lots of solid work but I never felt that my voice belonged to me – it always somehow belonged to the voice teacher. The therapist talked about why the nodules had happened, because of stress, smoking, drinking and my way of life. She said that they could be reversed because they were still soft, and didn’t need surgery. But she was asking me to change a whole way of life I have built up over years – my ways of dealing with being in the theatre and all the pressures. It affected every single aspect of my life – my posture, my full social life and my choice of food. I had to make a radical change and it seemed I would never enjoy myself again, so I felt very upset about it. When she played the tape of my voice I could hear a rasping sound and it was awful. I went home and thought and decided that I did want to change. I’ve given up smoking for 3 months now and it’s a big thing for me. I don’t eat very many dairy products now, so all that thick mucus is gone. Spirits and drinking – as an actor that’s a major part of your social life because we work at nights and we drink, and we keep on going all through the night. With drinking, I keep away from spirits as much as possible and drink wine or water. My breathing became better immediately, because of stopping smoking, and that was a positive result. I began to see that it was a series of choices and, although they were quite shattering at first, they aren’t actually definite forever. Now I’ve seen an improvement, and

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that I can do it, and I’ve realised I can lead a normal life and still have a good time! But I have to be responsible. I’m really aware of what’s going into my body now and the direct result it has on me and I can do something about it. Now that I’ve discovered there is an actual physical problem, it’s sort of a massive relief. I have a greater awareness of my voice now, and that has helped me.

Do you think that it is helpful that our direct voice work has made you more aware of your voice and how it works physically? I can now much better feel the things that you’ve talked about. I used never to feel those resonances, but I couldn’t talk about it as I was so frightened. Now I work and it somehow happens, the resonances. I think there’s a lot at college about voice that’s made far too technical, too mechanical. The voice teacher would say ‘ look at my diaphragm, it’s doing this’, and my diaphragm was supposed to do that, and if it didn’t, then I wouldn’t get some feeling supposed to happen in my bottom! Or I’d be told to ping all my consonants up through my nose to get the resonance across my sinuses, to feel it in my forehead – you just got whirls of technical stuff and it freaks you. It needs to be done in a much more holistic, spiritual kind of way, so it becomes part of you and doesn’t become a series of instructions. Once I relaxed about it and I didn’t go through those instructions, the resonance came, because it’s to do with relaxing so that the breath can go down. Then your diaphragm works properly and your ribs expand as much as they can. I have asthma, so I’m very aware of my breathing apparatus and know that stress affects it; I can see my intercostal muscles go into spasm and just can’t open up the space. ‘Expanding’ work relaxes me, so I don’t put pressure on the vocal cords to stop the breath. Then it’s one simple movement to form the sound on the breath going out. When I think of that, immediately all those resonators work and that’s a very comforting feeling.

The therapist’s story: 9 months after the above interview I met Rosemary 4 weeks after her second diagnosis when she was told that things had got worse, and that she now had hard nodules. The referral letter from the ENT surgeon said: ‘this actress has large nodules which are already looking white and hard as they move into a chronic state. The right nodule is larger than the left, and both cords are swollen. I think that I will have to operate at some point to remove the nodules, but would first like you to see whether you can help.’ At our first session Rosemary was clearly very upset and angry that her theatre voice work and giving up smoking had failed to get rid of her soft nodules. She told me about her long habit of heavy smoking (since the age of 12), her asthma, and about her history of sinus problems and nasal polyps at the back of her nose. These were three core ‘precipitators’ and, although some people can get away with all of these and more, Rosemary could not. Her voice was not severely disordered, but it did sound slightly rough, breathy and strained. Her pitch range was noticeably limited at the top of her range, where it sounded

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strained and breathy, and she ‘missed’ notes. She described ordinary speaking as being like ‘trying to talk through a pillow in my throat’. Nodules cannot usually be felt by those who have them, but Rosemary was continually trying to push her swollen vocal folds to work in a more refined way, and was straining her laryngeal muscles. She told me that sometimes on stage she felt that the voice could be clearer, but next morning it would be gone again. I described the nature of additional ‘temporary’ oedema, and how to reduce this happening. Rosemary was surprised that her voice had not improved during her week’s holiday, but I explained that it takes longer than 7 days if there is a chronic problem. Her personal energy and speech style were fast and high tension, and I explored with her the practicality of trying to have 1–2 hours silence every day – perhaps fitting that in after rehearsals and before the evening show. This was not because such a rest would resolve the nodules, but to allow her vocal folds to stop moving for a short period, so that any buildup of oedema might be arrested or even reabsorbed. It would also make her actually stop, to be silent and alone with time for reflection, awareness and rest. Rosemary rated herself as 8 on the 1–10 life-stress scale; she said that she took no exercise, because she felt that she was active enough during rehearsals and performances. When people say that they are constantly moving in their ordinary lives, I know that this certainly contributes to any physical fitness. But the point about exercise or active bodywork is that its purpose is itself; it enables the person to switch off from the ‘end-gaining’ activities of daily demands, to tune into body or energy levels, and move in space for the simple sake of ‘being’ in the body. We discussed her options for restorative bodywork in stillness or in movement. I noted that, in her conversational speech, Rosemary had a habit of poking her head forward as she spoke; she told me that she had not experienced any Alexander technique. Her breath pattern was upper chest with audible inhalations, suggestive of excess tension in the pharyngeal–laryngeal area. Although she was coping with big roles in performance, I was interested to find that she could sustain shh for only 17 seconds and ran out of breath after 7 seconds on a rather quavering sustained mmm. She had markedly poor subglottic air pressure support in her ordinary day-to-day ‘chatty’ voice and, together with her laryngeal over-constriction, these were major contributors to the continuation of her vocal nodules. As with so many actors and singers, the professional performing voice is usually better than the ordinary voice, and it is on the latter that voice therapy will often focus. I reassured her that these changes were well within her control and that she would get better. I made some practical suggestions about steam inhaling with the hypothesis that it would help to moisturise the whole lining of the vocal tract, and I told her about the research findings that hydration treatments were indeed beneficial in treating nodules. In terms of practical voice work, I introduced and demonstrated the connection of abdominal breath support to everyday phonation, and Rosemary started to explore this. Since her first diagnosis she had moved cities, and started sessions with a new voice teacher, Barbara Houseman. They came together to the second therapy session. I had worked as a voice teacher with actors for a number of years, and wondered if Barbara might find the specific and often repetitive nature of voice therapy exercises to be dry and unimaginative. But almost immediately the advantages of sharing ideas in constructive partnership became clear as we began to discuss ways to address Rosemary’s need to develop better head–neck alignment, and build up breath support. It was good to know that any

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suggestion I made would be followed up and extended in the period between therapy sessions, because Barbara and Rosemary were able to work together three times a week. So often a therapist is uncertain as to whether much between-session practice will actually be done. The kind of activities that I did with Rosemary in the next three sessions included the exercises below. Most are further described in the relevant chapters of Part 5: • Body: floor work and upright work for posture, to try to re-educate Rosemary’s head– neck alignment, which was particularly relevant to her negative voice patterns. • Breath: crescendo–diminuendo work on both voiceless sounds such as sss, and shh and voiced sounds – aiming for loudness and energy with no head poking or throat tightening. • Channel: yawn–sighs at regular ‘socially appropriate moments throughout the day’; whispered aah for deconstriction awareness and release. • Phonation: contrasting hard and balanced voice onset, using a whispered vowel becoming a voiced vowel, and then moving straight into a crescendo on that vowel with no excess tension. Repeated balanced onset vowels; thin/thick fold contrasts on gentle whimpers and downward gliding eee; reading aloud, and then speaking aloud, with alternate ‘open’ throat and ‘gripped’ throat settings. • Resonance: simple exercises to encourage the sensation of upper chest vibrations on an intoned aah with a relaxed throat as opposed to a tense throat, when very little ‘buzz’ is felt by the flat hand on the upper chest area. • Pitch: glides and sirens, with and without crescendo; chant speech – intoning sentences on one note, well connected to lower breath support; intoning sentences up and down a scale, to explore both upper and lower pitches. • Loudness: using ordinary conversational language (i.e. not dramatic texts) as if speaking over background nose in a pub. I chanted ‘rhubarb rhubarb rhubarb’ quite loudly as Rosemary raised her vocal loudness levels. (Nowadays I often use a recording made in a really noisy restaurant.) • Articulation: work to encourage forward vocal placing and slightly more energised lip and tongue-tip clarity, with the aim of substituting increased articulatory energy instead of the excess tense energy in and around the glottis. Barbara watched me doing these exercises and used them in her own sessions, but she also used her own extensive ideas to supplement mine. This intensive support helped Rosemary to work on her own, which further reinforced the new and healthier patterns of voice use. She was able to give us feedback about how exercises worked for her, and her questions and suggestions formed an invaluable part of the therapy package. After 3 months of voice therapy, Rosemary’s spoken voice was audibly improved at our fourth session. It was much less breathy and rough, with only the occasional sound of excess laryngeal constriction. She had a wider pitch range in her singing, and Barbara said that Rosemary could now easily produce a clear, flexible voice with no strain in their sessions together. Rosemary said that she only rarely felt any sense of throat strain after a heavy day, and estimated that her spoken voice was now a good quality for at least 60% of the time; she had been delighted when a senior actor had commented on how much better she sounded. She said ‘I need to have the right energy levels to keep it all relaxed’, because changing old patterns indeed takes concentration and effort. She had worked with great

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commitment and humour but, as my notes recorded, we all still thought that surgery was inevitable: ‘we discussed the fact that although her voice is much better, the hard nodules are still likely to be there; R will not be free for surgery until January 4, when her contract ends.’ Much to our surprise, her ENT examination found no sign of the hard white nodular tissue. The report said: ‘the right side has improved immeasurably and there is only some very slight soft fullness on this side. On the left side the fullness even smoother in nature.’ Surgery was no longer to be considered, but voice work and therapy should continue. Funding for our voice therapy ended after six sessions, and my notes show that that I felt Rosemary was ‘three-quarters there’. I was not worried about a relapse as I knew that she would continue to look after her voice, and continue to have voice lessons when possible. She had been greatly reassured that her work was effective in healing her vocal folds, and now felt in control of her own voice. She was able to finish her contract and go on to other theatre and film work with no recurrence of any problems. The joint voice work had become a new implicit memory within her body, and a strong part of the foundation to her many acting skills.

The voice teacher’s story: during voice therapy (This section is written by voice teacher and writer Barbara Houseman. I am grateful to her for allowing me to include it.) My first meeting with Rosemary was when she came to see me because her voice was hoarse and tired. This was not a new situation for her, because 9 months earlier soft nodules had been diagnosed so she was naturally very worried. I did my best to reassure her and to enable her to get through that evening’s show and without further damage. Three days later I went with Rosemary to see the laryngologist, and he diagnosed ‘hard nodules’. Rosemary was obviously very upset, as this was a worsening of a situation that she had tried hard to rectify the year before. She was presently performing in two shows and rehearsals were coming up for two new plays, both of which had parts that she really wanted to do. My first task was to give Rosemary solid support. I knew that it was essential that I asked her to miss a few performances to rest her voice. Actors feel very guilty about missing performances, because, even when they have a good reason and a competent understudy, they still worry about the problems it causes, and about what others will say. My second task was to help her to believe that her voice could and would get better. And of course, my third was to do the necessary practical voice work to bring about permanent improvement. Rosemary had great determination, and had learned much from her previous year’s experience. The problem was that, as she had improved, she had felt it less necessary to focus on her voice; she stopped working on it and started smoking again. She now realised that a long-term solution demanded a long-term commitment to voice care and work. It was crucial to rebuild her confidence in her ability to have a strong healthy voice – a confidence she had lost so long ago that she could hardly remember having had it. Along with

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her loss of confidence went a lack of faith that voice work could make a lasting difference, and I needed to restore this faith as quickly as possible. We went to see Christina, and so began a fruitful and dynamic partnership. I had never worked in this way before but had often felt such collaboration would be very positive, as indeed it proved to be. Watching the voice therapy gave me unpressured space in which to observe Rosemary’s voice and make decisions about the work needed. I knew how to help her develop healthy vocal habits to aid her recovery, but collaboration gave me new ideas and a greater confidence in my own choices. It also made the work much easier and quicker and that was vital for Rosemary’s morale. Rosemary had four sessions with Christina – first at fortnightly and then at monthly intervals. In between we worked as much as possible, often daily. Our sessions took two forms: individual warm-ups before each of her performances and gentle, unhurried sessions in between, to build new and healthier vocal habits. We also talked about the process on days when Rosemary was fed up with the whole business of practical voice work. This luxury of time was only possible because I was employed full time by the RSC who very much support work on the actors’ voices. However, it also meant that Rosemary and I were working very intensively and sometimes we just ran out of steam. The visits to Christina recharged us, gave us a new focus and impetus and, because I did not feel totally responsible for Rosemary’s voice, I was able to be even more clear-sighted and effective. Because of our strong three-way relationship, Christina and I had felt that we had invested even more than usual in the outcome of our work. We were both nearly as apprehensive as Rosemary when she went back to see the ENT consultant, 3 months after the diagnosis. I went with her, and shall never forget seeing her vocal folds on that visit: the nodules reduced from hard protruding bumps to hardly visible, soft swellings – on their way out! I was so pleased and relieved for Rosemary. I remember we got outside after the appointment and just hugged each other. Christina had been unable to come with us and our immediate thought was to phone her and tell her the good news. The investment we made in Rosemary’s progress played an important part in the success of the work. We were not caring experts dispensing our wisdom to aid a distressed patient, but three equally responsible individuals working together to solve a problem. In the process, all of us, not just Rosemary, learned a great deal. The collaboration allowed us the space to work in this way. Both Christina and I had been a little apprehensive about working together; we both feared that the presence of the other would make us redundant. This, I think, is a common fear that can deter people from collaborating. In our case, far from making either of us redundant, working together enhanced our effectiveness. Rosemary received the best from both of us, and this contributed to her speedy improvement. But the success would not have been possible without Rosemary’s perceptive and committed approach to the work. It is a reassurance to other performers in trouble that damaging vocal habits can be changed, however entrenched they may seem.

Fifteen years later: Rosemary’s own postscript (I am most grateful to this actor for providing these afterthoughts so long after her vocal problems.)

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I remember deciding as a teenager that actresses had husky voices and that to succeed I needed to alter my voice to fit this profile. Even in drama school training, I think a ‘voice beautiful’ model was presented, and it was more about going towards this idealised notion of a voice rather than keeping and working with the more natural sounding tone that one hears now in younger actors. This assumed identity, coupled with an anxiety to get things absolutely perfect, put a tremendous pressure on my vocal cords. Unfortunately this passed un-noticed at my drama school and, when exposed to the rigours of a major repertory theatre and the mad social life of a young actor, my voice collapsed. It was a frightening and sobering experience just 2 years into my professional life. It was quite an emotional experience to read the transcripts above. I found my naïvety and remarkably candid remarks a little shocking. The experience marked a turning point in my vocal production and practice. Since that time I have had hardly any voice loss and then only as a result of a viral infection. It was interesting to read that I felt that I had little ‘ownership’ of my own voice and felt unable to master the mechanics of theatrical technique as taught at my drama school. Interesting in the sense that, although I remember that feeling very clearly, it is now most definitely not part of my experience as a working actor. This is due entirely to the patience and hard work of the practitioners with whom I was very lucky to work at that time, and I am very grateful to the RSC who funded my treatment. It was through this team that I was able to take the process out of my head and into my body, and to realise that I needed a more holistic approach to my apparatus to avoid surgery. As I went into my 30s a hard examination of my lifestyle led me to battle furiously with an entrenched smoking habit. I am finally a non-smoker and my voice and breathing are all the better for it. I continue to take my voice seriously without giving it too much emphasis. I am still prone to analysis and anxiety, but I have accepted that, although I don’t speak like Dame Judi Dench, I do speak with a voice that is mine.

Recommended books Berry C. (1973). Voice and the Actor. London: Harrap. Houseman B. (2002). Finding your Voice. London: Nick Hern Books. Linklater K. (2006). Freeing the Natural Voice. London: Nick Hern Books. Rodenburg P. (1997). The Actor Speaks. London: Methuen. Sataloff R.T. (2005). Professional Voice: The science and art of clinical care, 3rd edn. San Diego, CA: Plural Publishing.

Chapter 30

The singing voice

When the singer Sade returned from a trip to African continent to trace her roots, an interviewer asked whether the community had been excited that she was a famous singer. Her answer was that since everyone sang, they were unimpressed with her ability or reputation. In our western world, although thousands sing regularly in choirs, solo singing is usually seen as a special skill, only possible for a few. Yet in past times, before the advent of broadcast or recorded music, many people sang as part of their ordinary lives. As Eldridge Cleaver wrote (1969) ‘song and dance are perhaps a little less old than man himself. It is with his music and dance, the recreation through art of the rhythms suggested by and implicit in the tempo of his environment and his life, that man purges his soul of the tensions of daily strife and maintains his harmony in the Universe’. There are few cultures that have no kind of singing. Recorded singing dominates the popular music industry, and acts as a backdrop to many people’s lives, with music from a huge range of styles and cultures. Many of those who listen also sing in their ordinary life – in the bath, to their children, at football matches, in church, synagogue or local choir. Amateur or semi-professional singers perform in choral societies and as soloists, and professional singers depend upon their singing voice for financial and emotional security. Singing styles include the ‘just let it happen’ sound heard in most renditions of ‘Happy Birthday’, opera, classical, musical theatre, folk, country and western, gospel, Indian raga, rap, pop, rock and many others. Some voices are unaccompanied and some have instrumental backing, at varying degrees of loudness. Voice practitioner groups may be consulted by any of these singers who find that something is stopping them from singing normally. Clearly singing teachers work primarily on the development of the singing voice, but they may also have a role as problem solver with a worried singer who is mystified to find that he can no longer reach his usual pitch or quality. Actors required to sing as part of their role may find the same thing, and ask a voice teacher for help. As we see later, singers make up a large proportion of the voice clinic caseload, and all speech and language therapists working in voice therapy will work with those in singing voice trouble. Singers can have any of the voice disorders described in Chapter 27, but the largest proportion will have some sort of muscle tension dysphonia.

Voice Work: Art and Science in Changing Voices. Christina Shewell © 2009 Christina Shewell. ISBN: 978-0-470-01992-4

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This may start with signs of temporary simple voice strain, but, if this becomes more regular or lasts for longer, a teacher should always suggest that his student seeks a medical opinion. This chapter looks at the nature of singing voice disturbance and what can be offered to the singer in vocal trouble. The word ‘singer’ is used to refer to anyone who sings, whether in private or public setting, but there is a special focus on how voice loss affects the professional performer.

Singing training The focus of most singing voice research has been on the classically trained singing voice. It is about this group and the musical theatre performers that Sataloff’s (1997) description of singers as ‘the vocal athletes of the voice world’ is most true. Both have intense training and practice in controlling the delicate intricacies of a range of vocal skills. Whatever the singing style, the trained singer works consciously to perfect the control of his vocal folds and vocal tract, and their coordination with body and breath. Singing has a need for ‘continuous adaptation of the muscular forces to the ever changing lung volume necessarily accompanying phonation, and the need to produce rapid and yet precise changes in subglottic air pressure’ (Sundberg 1987). Many singers are self-taught, taking pride in their ‘natural’ voice, and indeed often fear that a teacher will spoil that quality. George Gershwin asked Ethel Merman if she knew what she was doing to create her strong sound; when she replied that she did not, he told her never to go near a singing teacher. The implication was that singing lessons would ruin the spontaneity of her individual sound. The problem is that the untrained voice is fine so long as all goes well, but of course it will not always go well. The demands of illness, tiredness, a difficult acoustic space, a heavy role, new repertoire or emotional upset will affect a singer. Good singing teachers offer extension, protection and survival techniques that the self-taught singer may never discover. As dancer Martha Graham (1991) described: ‘technique is a language that makes strain impossible’. Singing teacher Richard Miller (1986) wrote ‘technique represents the stabilization of desirable co-ordination during singing . . . [it] can be “computerized” in the brain and the body of the singer.’ Over the years I have worked with singers, it seems that those with no training may survive the healthy 20s with few problems, but are more likely to develop some sort of vocal strain in their early 30s. Singers sometimes ask: ‘Why would I develop this problem when I’m not doing anything different to what I’ve always done?’ But this is exactly the point – even though still young, the voice is no longer quite so good at restoring itself, and some ‘underpinning technique’ is now needed for their singing demands.

The emotional effects of singing voice loss A vocal problem can be upsetting to anyone who can no longer experience the release and exhilaration of their sung sound. It is a deeply disturbing threat to any whose reputation

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and self-confidence depend on the quality of their singing. The understanding and respect of a supportive doctor are very helpful, but do not always happen. Doctors deal daily with severe illness and do not always sympathise with the anxious singer who describes a subtle problem of pitch control but appears to be talking normally. But just as a surgeon cannot work without his hands, so a singer cannot work without his particular singing voice. As the late laryngologist Van Lawrence would say, a singer is the world expert on the sound of his own voice; if he says there is something wrong, there is likely to be a real problem. Performers who are worried about their voice quality are not indulging an overactive artistic temperament; they face a threat to livelihood, morale and creative effectiveness in the world. Many non-singers can talk loudly and fluently, but have an immense inhibition about singing in front of others. It is partly because there is a pressure to ‘get it right’ in musical terms, but there is also a sense of exposure in those long intoned notes. Some Jungians believe that the sung voice connects us to a very early primal preverbal stage, and accesses primitive and highly charged areas. When we play an instrument, we show the sound of that instrument, and if something is broken, we can take it to the menders. The singer ‘plays’ a sound that comes from inside himself, and any impairment can strongly affect the way that he feels about himself. Comments made by some of my clients have included: ‘singers live around their vocal cords, mine felt broken and I thought I’d never sing again’ (classical singer); ‘singing moves you on in life; I’m stuck if I can’t sing’ (rock singer); ‘I am my voice – if it’s alright, so am I, but when it’s in trouble, I fall apart’ (jazz singer). Singer and singing voice specialist Dinah Harris said ‘before my voice crash I was defined by singing, afterwards I was just a person who happened to sing. You can trust nothing when it happens; because you cannot trust your voice, you can’t trust yourself. It’s so lonely’ (personal communication, 2004). International opera singer Lesley Garret (2001) wrote of her own voice loss after a period of both emotional and physical disturbance ‘I had lost my ability to sing but I had also lost all memory of what it felt like to sing. Singing had been instinctive, like breathing. What I had lost was not just my muscular memory of singing, but my emotional memory of it too.’ I often recommend Lesley Garrett’s book to anxious singers who feel isolated by their voice loss, and may also tell them of her radio interview words: ‘I lost the opportunity to express myself. I lost my joy.’

The incidence of singing voice disturbance As we saw in Chapter 28, Titze et al (1997) reported that, although singers made up only 0.02% of the US workforce, they formed 11.5% of the clinic caseload. This kind of proportion is probably reflected in many voice clinics around the world. In the 1990s, my private voice caseload in London’s Harley Street had an intense focus on work with performers. At the end of one year, an analysis of the cases found that out of 85 performers in vocal difficulty, 23 were actors, 6 were broadcasters and 56 were singers, including actors singing in music theatre (Shewell 1997). The following year I looked at the proportion of singers attending a National Health Service special clinic for professional voice users at the Royal United Hospital, Bath (Table 30.1). Of those 17 singing clients, 12 were diagnosed with muscle tension dysphonia.

482 Voice Work: Art and Science in Changing Voices Table 30.1 Analysis of professional voice users seen in six performing arts medicine clinic sessions.

ENT diagnosis

Professional voice user type

Paralysed vocal fold: 1 Vocal fold haemorrhage: 1 Reinke’s oedema: 1 Pink/slightly oedematous folds: 2 Vocal fold polyp: 1 Vocal fold nodules: 2 Psychogenic (complete aphonia): 2 Muscle tension dysphonia: 16

Company director: 1 School teacher: 1 College lecturer: 1 Professional actor: 5 Acting student: 1 Singing teacher: 3 Professional singer: 10 Amateur singer: 4

Total patients seen: 26 (7 male, 19 female); total singing clients = 17.

All these figures certainly support the need for a singing teacher to be a regular part of a voice clinic team. Davies et al (2007) looked into the involvement of singing teachers in specialist voice clinics in the UK and found that although only eight clinics had a singing teacher on the team, many more wanted one to be involved. Most of the 42 questionnaires analysed said that they would value having a list of local singing teachers. Such contacts are good for both teachers and therapists and should be encouraged in any way possible, as that partnership can only benefit the singer.

The singing voice specialist The American Speech–Language–Hearing Association (ASHA) have issued a joint statement with the National Association of Teachers of Singing (NATS): ‘The preparation of the teacher of singing needs to be augmented by the inclusion of training in anatomy and physiology and in the clinical management of voice disorders. The preparation of the speechlanguage pathologist who works with singers needs to be augmented in a parallel manner to include instruction in vocal pedagogy (the art and science of teaching voice) and vocal performance.’ (Reproduced with permission of ASHA © 2005) The dream of shared areas of knowledge continues to advance, with increasing opportunities offered in courses and conferences, but there is considerably further to go. More teachers are learning about anatomy and voice disorders, as is clearly demonstrated in several recent books on singing pedagogy. However, few speech and language therapists/ pathologists receive training in singing teaching and performance, and more short courses are needed. Many continue to feel a sense of inadequacy when faced with a singer in vocal difficulty, even though they have much to offer. Emerich et al (1997) introduce the idea of the well-trained singing voice specialist (SVS), who ‘aids in the remediation of voice disorders, utilizing singing exercises specific to the patient’s vocal condition’. There are now a number of such teachers with special skills in working with the damaged singing voice. They can also offer practical techniques to spoken voice practitioners, not least because there is evidence that singing exercises can be good

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for the voice in general. The development of skills such as increasing the pitch range, being able to alter and control pitch and loudness together, the use of long notes or phrases on one breath and other related techniques can all help the development and repair of the spoken voice. Emerich et al say ‘singing therapy is good for non-singers’, and their chapter contains a number of useful exercise suggestions. I would add that singing can simply make us feel good!

Different singing styles Singing is generally a high-energy activity and high levels of muscle tension are often needed. There can be great deal of work going on to create an impression of an effortless flow of sound. In their paper about the Middle Eastern singing style, Hamdan et al (2006) ask a question relevant to all singers: can muscle tension be ‘an acceptable physiological finding in singers, or is it a sign of vocal stress and inappropriate technique that may lead to vocal dysfunction?’. The answer is of course ‘it depends’. So long as muscle tension is appropriate and well produced with no damaging strain, it can be a healthy part of a singer’s technique. Some singing styles have an inherently tighter pattern of ‘laryngeal biomechanics’ – the way the larynx and vocal tract functions. Koufman et al (1996) examined 100 healthy amateur and professional singers to assess patterns of laryngeal tension during normal singing. They found that muscle tension was lowest in those singing choral music, art song and opera, higher in jazz, pop, musical theatre, bluegrass, country and western, and highest of all in rock and gospel singing. Such findings are relevant in training or remedial work, and do demonstrate the vital need for singers in those higher voice stress groups to have enough training in technique to protect their voices. As a teenager, I had little idea why different singing styles sounded so different to each other. I assumed that Dolly Parton, Barbara Streisand, Nina Simone, Billie Holliday, Maria Callas, Mahalia Jackson, Joan Baez and Julie Andrews were born with ‘that kind of voice’, even if it was later honed by practice. Many years later the crucial role of the complex vocal tract options became clear. We can never sound like those great singers, but we can learn to use the shapes of their style of voice. The Estill Voice Training System (and the methods that it has inspired) clarifies many of those options, explaining and demonstrating different combinations of structural conditions, and many singing teachers use the system as part of their teaching. Not all singing students need to know exactly how all the sounds of their singing style are made, because, for some, an analytic approach may ‘get in the way’. The long used tools of image, imitation and listening remain important in the teaching of singing.

A singer’s questionnaire Voice clinics with a special interest in singers may ask them to complete a general questionnaire. Sataloff (1997) provides a long and comprehensive example that generates a mass of information. Below you will see the topics that are included in a shorter questionnaire, developed in my own clinical practice. Such detailed forms may not be appropriate in your

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work, but the questions give an idea of the many areas that can be relevant to the singer in trouble.

Section 1: Voice issues In your own words, can you describe your voice problem, and how it makes you feel: 1. How long have you had the voice problem and how did it start? 2. Please describe any voice problems that you may have had in the past and any treatments. 3. Has anyone in your family had voice problems? 4. Is your voice quality impaired? If so, is this all the time? During singing? During a performance? After a performance? And, if so, how long afterwards, and for how long? 5. Do you have any of these symptoms: vocal tiredness or weakness, frequent throat clearing, coughing, heartburn, bad taste in mouth in morning, dry mouth or throat, sensation of lump in throat, discomfort in throat – tickle, pain, ache? When and where? Other symptoms? 6. How is your singing voice affected? 7. Other.

Section 2: Performance issues 1. Is singing your profession, part of your work or a hobby? 2. How would you describe your style of singing? Use any terms that you feel best describes you, e.g. pop, classical, folk. 3. Can you describe the material that you sing? 4. In what sort of spaces do you usually perform, and in what sort of background noise? 5. What kind of music provides your backing? 6. Do you always use a microphone? 7. Do you travel much as part of your work? 8. How many hours might you perform in a typical week? A typical month? 9. How much have you sung professionally in the last 6 months? 10. What are your current pressing singing commitments? 11. Do you have any particular long-terms goals for your singing career? 12. Do you warm-up before a performance? If so, for how long? 13. Do you do a cool-down after a performance? 14. If you have had training in singing, or in the spoken voice, please describe here, including any current lessons. 15. Do you feel that you have a reliable and trusted technique that enables you to mostly sing safely? 16. If you practise regularly please describe how long you spend in this. 17. Are there demands on your voice separate to your singing? 18. Other.

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Section 3: General health issues Do you have any of the following – circle and describe: • Digestive problems – including any known reflux, or neck, shoulder or back problems • Asthma or breathing problems, allergies, headaches, tonsillitis; nasal or sinus problems, ear problems • Hormonal issues • Other Please comment on these issues: • • • • • • • • • • •

Exposure to environmental pollutants Smoking Current medication Fluid intake: how much, and what, do you drink each day? Alcohol intake Diet – typical and any allergies Past operations, accidents or serious illnesses Any recent general anaesthetics Hobbies Exercise Occasional or regular complementary medicine care or bodywork? For example, acupuncture, homeopathy, massage, pilates, Alexander technique.

Key singing voice problems Whether or not you use a formal questionnaire, it is clearly important to find out what the singer finds wrong with his voice. I use these 11 headings as a guide to my investigation of a singing problem. The singing teacher will of course listen to each of these; the voice teacher and therapist can carefully listen to the spoken voice, and ask the singer about the others. (I am grateful to singer and singing voice specialist Dinah Harris for her outline of issues that may present a problem to a singer (Harris et al 1998). I have adapted these to form a simple assessment of the disturbed singing voice.)

Spoken voice quality and stamina Singers talk far more than they sing, and their habitual spoken voice patterns can have a significant direct relevance to their sung sound – either positive or negative. Meunier (2007) found that, of 22 singing students (predominantly in the classical style), those who had vocal problems had not had spoken voice training. Gullaer et al (2006) agree that ‘it is important to develop an approach integrating two teaching methods: singing and voice-speech’. Many singers are unaware of the links and tend to think voice difficulties are inevitably to do with singing technique or demands.

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Spoken voice practitioners have much to offer in this area. The GRBAS perceptual voice assessment (described in Chapter 4) is of use only if a singer has a severe voice disorder that significantly affects the spoken voice. As it looks in detail at eight aspects of vocal sound and function, the Voice Skills Framework or full Voice Skills Perceptual Profile (VSPP) can provide useful insights into a singer’s habitual body and voice use, and this is illustrated in the story of Sandy, a jazz singer, with Box 30.1 demonstrating her Voice Skills Framework.

Box 30.1 The Voice Skills Framework: Sandy – singer 1 Body: posture, movement, muscle tension, vocal tract sensation, health and body No back or neck problems – says her mother always emphasised need for good posture in both horse riding and ordinary life. S is unusually aware of lengthening spine, and head–neck alignment. No excess tension palpable in shoulder and neck muscles, but slight tension around larynx and tenderness and tightening in cricothyroid. No discomfort generally but feels sore after a late night or lots of talking. Feels that she is ‘making an effort around my larynx’, slightly painful, hot and uncomfortable – with the sense of tightening and straining to bring out sounds. Aware of her own stress and how to manage it, rates herself as ‘generally a 3–4. Fit and well – no health problems and goes to gym twice a week for an hour each time. On feet all day at moment, as waitress in busy restaurant. 2 Breath: placing and control Shallow upper chest breath pattern, in assessment and conversation. Quick shallow breath intakes, with ‘audible gasping’ sound on counting Sustained sss: 26 seconds. Sustained zzz: 17 seconds – increasingly whispery with marked pitch/loudness fluctuations. Audible strain towards end of longer sentences – not all the time, but more when tired. 3 Channel: face, lips, jaw, tongue, soft palate, pharyngeal, laryngeal No apparent excess lip tension, good range movement. Slightly close jaw, with very limited range of movement. Rather ‘backed,’ tongue quality with limited range of movement. Soft palate fine. Slight pharyngeal constriction. Marked laryngeal constriction and audible breath intake at times. Says that sneezing is very painful in her laryngeal area. 4 Phonation: rough, breathy, creak qualities, phonatory stamina and other features Roughness mild but continuous. Continuous breathy quality – marked. Slight creak at the ends of sentences – a bit more than normal limits. 5 Resonance: features of head, oral and chest resonant quality and focus of oral placing Reduced head resonance quality, more obvious chest quality; voice lacks ‘carrying ring’.

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Sandy found it very hard to get any sense of ‘buzz’ – said she felt that it was all in the ‘middle of my mouth and doesn’t reach my lips’. Backed oral resonance quality. 6 Pitch: centre, range and intonation patterns/variety Slightly low mean – just within normal limits, but she feels it is significantly lower than a year ago – we discussed relevance of swollen vocal folds. Increasing breathiness as she goes up glide or scale ‘cracks ‘at top, where she feels that she has lost half an octave. Lively and energised intonation patterns; wide variety within a possibly slightly limited range. 7 Loudness: overall loudness level, variety and control, and use in emphasis Slightly over loud at times, even one to one with me – probably a result of her pushing the voice. Normal variety of loudness – says that she has to talk loudly all the time in the restaurant. Obvious increased vocal tact constriction as she increases loudness in speech; I could see excess tension in muscles at front and side of neck as she crescendoed on a long vowel. 8 Articulation: consonant and vowel clarity, pace, pause, fluency, rhythm All articulation features fine.

Singing voice quality The singer may use a range of words to describe this, such as rough, tight, constricted, breathy, creaky, weak, unpredictable. She may not be able to get a particular quality that is an essential part of her singing style. Examples include the clear light quality of early music, the high yell of a rock singer, the particular qualities in classical Indian singing or a quick flexibility of phonation qualities. If you listen to a musical theatre or popular modern singer, you will notice that the phonation quality often changes with the emotional meaning of the words; indeed this may be part of the sensitivity of those singing styles. In the traditional classical voice, this is not meant to happen, and the phonation stays smooth and free of any irregularity, with just a regular and controlled vibrato at times.

Singing voice stamina The singer may find he has problems in singing for any length of time without strain, pain or deterioration of quality. This may happen quite quickly during half an hour of practice, or develop over the course of a performance or long run of a show.

Singing voice sensation There may be discomfort such as an ache, pain, tension or a sensation of a lump during singing. This may be in the tongue, jaw, pharyngeal area, in any of muscles above, around and within the larynx, or in some other part of the body.

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Pitch range The singer may have problems with his higher notes, lower notes or the middle of the range. This problem may be constant or unpredictable, and most singers say that the latter is the most stressful.

Smoothness of changing pitches or registers A singer may develop difficulties in the ‘break’ (passagio) as he moves between lower and higher notes. Most styles aim for a smooth laryngeal adjustment in these pitch changes between what many call ‘head voice’ and ‘chest voice’, and considerable practice can go into making this sound effortless. Sometimes even an experienced singer can suddenly find that this control becomes a problem.

Ability to sing loudly or softly (dynamic range) The singer may find an impaired ability when he tries to sing loudly ‘on full voice’ or to sing very quietly. Singers learn to manage the particular challenge of producing high pitches at soft loudness level, and may find that this skill becomes impaired.

Voice onset There may be problems with achieving a balanced voice onset, so airflow and vocal fold closure may not happen simultaneously, resulting in a hard or breathy onset. Some singers find that they can no longer use the flexibility of onsets that their singing style requires.

Special voice qualities Different styles and cultures have different qualities (e.g. vibrato, yodelling, crooning, yelling, belting) and these particular demands may offer fascinating challenges to voice practitioners. Practitioners then have to work to understand that specific quality to devise appropriate remediation. Much of my detailed work with a very successful classical Indian singer focused on her inability to do the high ‘shivering bleat’ kinds of sounds needed for many of her ragas. The P’ansori singers of South Korea use alternating throat tension and release as a deliberate aesthetic technique

Other Singers, like anyone else, can always present a voice practitioner with an unusual and surprising vocal challenge! One classical soprano started to notice a strange buzz just above

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her larynx as she sang at particular pitches. Although almost inaudible to even an attentive listener, it ruined her confidence and vocal quality as she struggled to control it. Careful observation with videostroboscopy found that she had a small polyp on one false vocal fold, which vibrated at certain frequencies with a tiny buzzing noise.

Emotional issues The conductor Ben Zander told a story about the young Jacqueline du Pre who was taking part in a children’s music competition. Seeing her skipping along the corridor, singing and smiling, one of the accompanying mothers said ‘I can see you’ve just finished playing!’ ‘No,’ said Jacqueline ‘I’m just about to go on.’ Not all professional voice users can feel that performing joy. Issues of lack of confidence, nerves and stage fright can be a permanent strand, or a new or greater feature in any performer’s life. The voice practitioner can have a very supportive role here, but it is a specialist area, and the right referral is important. My competence in counselling and body release skills is certainly not adequate to offer anxious singers all that they need and I usually suggest a specialist consultation. In the UK, the British Association for Performing Arts Medicine offers expert practitioners in this field. The voice story below shows how both the Voice Skills Framework and key singing voice problems were used in work with a young singer with vocal disturbance.

Sandy: spoken voice analysis on page 486 Sandy studied flute and singing at a major music college, where she chose to specialise in jazz. When she left, she performed extensively in clubs, restaurants and bars, and as a session singer. She had plans to further develop her singing with recording and higher profile performing. However, at 24, after a couple of successful years, she developed vocal problems and had to turn down a number of job offers, as she could no longer trust that her singing voice would last the night. When I met her she had done no public engagements for 3 months, was only singing occasionally with friends and working as a waitress in a busy restaurant. She had seen an ENT surgeon 4 weeks before, who had found swollen and reddened vocal folds. Sandy told me that she was slightly hoarse after even half an hour of singing. ‘Actually 5 years ago, when I was working in bars, my voice would often be completely gone by the end of an evening, but I ignored it and it always got better. But in the last year it’s a much more obvious problem and if I go out for an evening my voice goes and it’ll be sore next day. I can cope with that but the real disaster is in the last 6 months, because it’s affected my singing. I get hoarse and I can’t get those higher notes. I can “wing it” because my sound is quite “bluesy”, but it feels so unreliable now.’ She said that, because her singing style and voice had always been low and slightly husky, she did not want to aim for a completely ‘smooth’ phonation quality. What she wanted was better stamina and pitch range in her singing, so that she could again feel confident in accepting gigs. She hated the sensation of strain in her speaking voice when talking over noise or for long periods of time.

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Assessment of key singing voice 1. Spoken voice quality and stamina: see Box 30.1. 2. Singing voice quality: ‘fine for the first 10 minutes, but then it gets breathy and tight, and I lose any fine control.’ She had always liked her slightly husky tone, but this was now too noticeable. 3. Singing voice stamina: although she could push through and keep going for an hour or so, she would develop an increasingly low pitch, general roughness and throat discomfort. 4. Singing voice sensation: sore, dry and painful, after a short period of singing. She pointed to two areas – at the top of her neck just below the hyoid bone and around the thyroid cartilage. 5. Range of singing voice: she used to have a three-octave range, but was now hardly able to get past A4 (440 Hz) without noticeable air escape and strain in phonation quality. 6. Smoothness of changing pitches or registers: Sandy’s glide sounded smooth at lower pitches but there was a noticeable ‘break’ when she tried to move into her higher range. 7. Ability to sing loudly or softly (dynamic range): Sandy could produce high volume sounds on crescendos and calling, but it was done with significant excess tension in her neck muscles. 8. Voice onset: mixture of breathy and hard onset features in intoned vowels; audible hard attack in speaking pattern. 9. Special techniques: no special techniques needed for her style of singing. She said that she just wanted to recover the flexibility that she used to have, so that she could again be emotionally expressive in her songs. 10. Emotional issues: Sandy described herself as usually fairly ‘laid back’. Although naturally distressed about her voice, she was reassured by the ENT examination that she would get better. She was anxious about how long this would take, because she had the chance to audition for a cruise ship job in 3 months. She was highly motivated to work on her voice and described herself as ‘very disciplined when I want to do something’.

Sandy: voice work plan notes after the above assessment 1. Steam inhaling and general voice care to protect folds and encourage vocal fold swelling to be reabsorbed. 2. Gentle massage round the larynx to loosen extrinsic laryngeal excess muscle tension. I will do and show Sandy how to do this herself. 3. Place breath lower in body, and coordinate with balanced onset phonation work. 4. Sandy’s lively lip movements camouflage the considerable constriction that she holds in jaw, tongue, pharyngeal and laryngeal areas, so work to increase her general awareness of this and do practical deconstriction work. Also increase tongue range of movement.

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5. Explain and explore option of deliberate use of head resonance ‘ring’ as useful over noise, in both speaking at work and in singing. 6. Work on vocal fold flexibility (thin/thick and long/short) and extend pitch range gradually when possible. 7. Strong loudness work with no strain – include calling exercises. 8. Specific exercises relating to the key singing voice problems. I told Sandy that we would probably work for six sessions together, and suggested that, after four, she should start some good singing lessons to recap and further develop technique. Sandy did well with six sessions of practical voice work. She learnt how to manage her spoken voice so that it could last throughout an evening, and her singing pitch and quality improved hugely. Although she was not successful in her audition, she told me that she was delighted with her voice. She is now doing well with her singing career.

The management of singers’ voice problems Using the 85 performers described earlier, I found that they could be categorised into three groups according to the kind of management they needed (Shewell 1997): 1. Emergency: 13 clients (15.29% of total performer caseload). Clients who needed immediate voice therapy attention in order to enable them to perform in the imminent future. They usually then had at least one follow-up session. 2. Protection and support: short-term management – 37 clients (43.53% of total performer caseload). Clients who had two to four sessions of voice therapy for vocal survival strategies and ‘voice mending’; 13 were recommended to go to singing or voice teachers for further work on technique. 3. Long-term vocal education (35 clients: 41.18% of total performer caseload). Clients who needed six or more sessions of in-depth vocal education and practice, to resolve a voice pathology or change misuse; 27 were recommended to go to singing or voice teachers for further work on technique, and most of these had had very limited or no previous training.

Emergency care of the singing voice An article in the International Herald Tribune on 22 August 2007 quotes a leading tenor who makes the valid complaint that professional singers face the choice of performing and being attacked if they sing one false note, or being attacked because they pull out of a performance to take care of themselves. Although no performance is worth the risk of vocal fold damage, as singing teachers well know, pressures of job and reputation do push many singers to take that risk. Both medical and voice professions are likely to be involved in the support of singers in such a situation.

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Medical care of singers needing emergency voice attention Mishra et al (2000) describe what can be offered to a singer with a voice problem and an imminent performance. Examining 40 singers who came to their clinic with acute voice problems just before a show, they found that on average opera singers sought help 69 hours before the performance demand, whereas musical theatre singers waited until an average of 38 hours before. Although I have certainly found that some of this latter group may hope that they can ‘wing it’ while things sort themselves out, this is often shaped by financial considerations rather than an unwillingness to be proactive in seeking help. Mishra et al write that the doctor has three roles with the performer who is in vocal trouble 24–72 hours before a performance: to make a prompt diagnosis, provide treatment and determine the safety of performance. They describe three steps that enabled 85% of their singers to manage the full performance, and these are typical of most medical management: 1. Medication: steroids were prescribed when necessary to reduce any vocal fold inflammation and oedema, when this was causing problems in pitch range and strength. Sixty per cent of the singers were given antibiotics, in case there was any bacterial infection. 2. Voice rest: 32 of the 40 singers were advised to rest their voices for at least some period, but only one singer was told to have complete silence. The authors quote the late laryngologist Norman Punt (1979): ‘Don’t say a single word for which you are not being paid!’ 3. Increased hydration: all were instructed on how to do this. They also say that voice practitioners can be useful with the inexperienced singer with acute vocal problems; I would say that appropriate ‘emergency’ voice work is very useful with any singer at any level of experience.

Voice practitioner care of singers needing emergency voice attention 1. Acknowledgement of significance of problem: the singer with a voice problem will have both internal and external pressures. As we have seen, the internal pressures may include a fear about recovery time, lack of confidence in the voice and loss of self-esteem. External pressures may be the demands of the current work, a threat of a loss of earnings and worries about others ‘finding out’, with a resulting possible damage to reputation and career. A simple statement acknowledging the difficulty that the singer faces immediately gives the message that its significance is recognised; the working relationship gets off to a good start and the singer may feel less isolated. Then the next steps of exploration, assessment, reassurance and action can take place 2. Immediate practical voice care suggestions: these need to be very structured and specific, so the singer knows exactly what to do and why. (Details are described in the handout in the last chapter.) Good voice care strategies can make a huge difference to all singers. Timmermans et al (2005b) review the research and conclude that, although it is vital to have in-depth medical investigations, diagnosis and treatment, recent research does indeed prove that ‘hydration and vocal rest are beneficial’. Although karaoke singers may not be taken as seriously as the employed singer, such singing is a hugely popular

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3.

4.

5.

6.

7.

past time and karaoke singers’ voices matter greatly to them. Yiu and Chan (2003) found that, when karaoke singers had a 1-minute break to drink 100 ml of water after singing each song, they were able to sing significantly longer than those who did not drink any water or rest. Care of emotional and body state: for many performers, their vocal problem is both a cause and a symptom of their distress. As in all voice cases, it is essential that the counselling skills of exploration and understanding be incorporated into the session. Equally important is attention to the way that anxiety may be tightening breath, muscles and joints, because this will only make a singing voice problem worse. ‘It is difficult to determine where the instrument of the singer leaves off and where the instrument case begins. In any event, the singing instrument is dependent on the condition of its carrying case’ Miller (1986). The practitioner can use his hands to work directly on tight shoulder, neck and laryngeal muscles, and use the semi-supine position for breath and release work. He can also introduce, or remind the performer, of the range of physical release movements that can be incorporated into any exercise routine and performance ‘warm-up’ or ‘cooldown’ sequences. In my experience of working with singers in crisis, such release work is usually needed before any simple voice exercises are suggested. Many voice problems are about overdoing things and pressured singers may need to start by a period of not doing. Vocal exercises may add activity to a mechanism that may first need to stop for a while. Silence and moving out of it: the singer will almost certainly need to rest his voice with periods of silence. He should also have clear guidance as to how then to gently warm up into voicing. Appropriate well-supported phonation exercises and gentle up and down humming sounds are examples of such easy voice. Avoidance of extra vocal stress: the anxious singer will of course avoid noisy environments but they may also need to be warned to avoid loud shouting, laughing or crying. Murry and Rosen (2000) looked at three professional singers who had developed vocal fold haemorrhages after prolonged crying. Singers can be reassured that this is a rare result of crying but should know that long strong periods of crying can occasionally have negative effects on the voice. Crying may involve irregular breathing patterns, frequent tight vocal fold closure with high breath pressure beneath, loudness levels that may be higher than normal singing levels, narrowed vocal tract and a strained voice quality. If we add to this the increased tension bodily levels, posture and amount of movement in the body, we can see why crying can be tiring for the voice! Murry and Rosen contrast ‘cruising’ (continuous vocalisation) and a series of interrupted voicing (the classic jerky sobs). The former are less injurious than the latter. Of course we can rarely control our crying but it seems possible that the old adage to ‘really let it out’ in long wails, with an open vocal tract and lots of breath support, may be less damaging than over-constricted, hiccupping gulps and sobs. Appropriate voice work – personal recording: anxiety tends to block full absorption of what is said and affects memory; a recording allows a singer later to play back what was suggested and to hear the reassurance and calm plan of action. Offer of personal contact: if the performer knows that he can relatively easily contact the practitioner for support and answers to specific queries, more serious problems or anxieties may be avoided. Obviously the decision to share mobile numbers or email

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addresses obviously belongs to individual practitioners, but, with sensible discretion, some contact can usually be given. 8. Option of liaison with agent, company manager, singing or voice teacher if the performer wishes this to happen. Some actors and singers request this contact, whereas others want to keep the whole matter absolutely secret.

Voice story: emergency voice management in a singer Sian was a musical theatre singer with an international reputation, and was brought in to star in the revamped version of a big London musical. Ten days before opening, she developed a lung infection. This cleared up fairly quickly with antibiotics and she had no associated laryngitis. However, 2 days before opening I was telephoned by the company manager who told me that her voice had ‘seized up’. Her voice was rough, breathy and strained, and she had lost the flexibility of tone and huge vocal energy that was her trademark. ENT examination found some laryngeal constriction but otherwise all was normal. I went to see her in her hotel room. When I felt her shoulders, neck and outer laryngeal muscles, all were tense, as were the muscles in her abdominal area, which she described as ‘rock solid’. She was so scared of failing on the first night that she could not sleep. As she was away from all the normal network of support in her own country, she did not know where to turn for help. In spite of her reputation, she did not feel able to show her terror to anyone in the company. It can be very lonely to be the star of the show. I took Sian through a series of stretches, shoulder loosening, arm and torso swings, and self-massage. In addition I made her an individual tape-recording, which took her through a lying down progressive muscle release sequence. I also arranged for her to see an excellent masseur both that evening and the next afternoon, the day before opening night. After the physical release work, I took her through about 5 minutes of easy voice and vocal fold flexibility exercises, but the purpose of these had as much to do with reassurance as with remediation. Sian needed to hear that her voice could still sound and move, and this allowed her to re-access a hope and belief in herself. We booked a follow-up session next morning, and Sian told me she had used the recording when she went to bed and in the middle of the night when she woke in panic. She said that my slow, quiet voice, and the fact that she had to follow a definite sequence, had helped to calm her. In that second session we further consolidated her ability to let go, in both stillness and movement, and did some energetic voice exercises. Although not completely happy with the sound, Sian felt much more optimistic and agreed that she felt able to have an individual session with the musical director to run through some of the songs. This session went well, and further boosted her morale. She was able to open as planned on that first night; her singing voice was not perfect, in terms of her own standards, but her restored confidence allowed her strong stage presence and performing energy to come through well enough for excellent reviews.

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Longer-term remedial voice work Once a singer is using good voice care strategies, practical remedial voice work can take place. Singers are usually reluctant to make any sound that they do not see as ‘good’. In working to improve vocal fold swelling, we may give very quiet, well-supported pitch range slides to flex and thin the folds. At the higher pitches, the singer’s voice may ‘crack’ or become breathy, and she may hate that sound. We may need to be explicit about the natural disturbance that this causes to a ‘sound perfectionist’, and reassure the singer that no damage will result. Making the sound has a therapeutic benefit; we are doing exercises for voice muscle and voice health, not for singing tone. As I am not a singing teacher, the remedial voice exercises used for the key singing voice problems are different to singing exercises. The focus is on improving the healthy structure and function of the whole vocal instrument. The list below shows where relevant exercises can be found in Part 5. 1. Spoken voice quality and stamina: work will be based on the observations made and organised under the Voice Skills Framework headings. (See examples of Sandy above, and Janet in Chapter 6.) Appropriate exercises can then be designed to improve any of the weaker areas, and may come from any of the chapters in Part 5. 2. Singing voice quality: we need to identify the exact quality that is a problem for the singer, and writing down the precise descriptive words that he uses can be illuminating. We need then to work out what should be happening and what is not happening, in terms of its biomechanics. We will then be able to choose exercises to change any negative patterns. Chapters 20 and 21 are likely to be particularly relevant. 3. Singing voice stamina: we cannot simulate the demands of a practice session, rehearsal, show or run of shows. We can, however, explore how a singer uses her body and breath to support long strong voice and avoid vocal fatigue. Chapter 21 includes some ideas on building phonatory stamina. 4. Singing voice sensation: bodywork is relevant here, and described in Chapters 17 and 18. Although a practitioner may feel confident to gently massage the neck and laryngeal areas, he should always know a qualified physiotherapist, osteopath or chiropractor whom he can recommend to singers. Hydration levels are also relevant, since a dry throat can cause a range of uncomfortable features 5. Pitch range of singing voice: see Chapter 23. 6. Smoothness of changing pitches or registers: see Chapters 22 and 23. 7. Ability to sing loudly or softly (dynamic range): Chapter 24 contains ideas relevant to the control of dynamic range. 8. Voice onset: exercises are described in Chapter 21 on phonation. 9. Special techniques: ideally these would be left to an experienced singing teacher – if the singer has one. If he does not, it may be necessary to work out how the sound is produced, and then design related exercises. This can be challenging for the practitioner’s creativity and ingenuity! One of my clients used a technique that he had copied from blues singer Bobby Bland, a quality apparently known as the ‘love throat’. This was a hoarse gurgle that Bland said he got from the emotional style of a gospel preacher. My client practised by turning his head sideways to ‘block off’ his throat, and had not surprisingly run into vocal trouble. Our challenge was to find a healthier way to create a constricted love throat, something that we developed with a careful mix of extra tension in epilarynx and pharynx.

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Example of practical voice therapy session exploring phonation quality and pitch control Voice story: Lynne Lynne was a young student with vocal nodules. After five sessions, her spoken voice had greatly improved. The nodules were still present but much smaller. As a keen singer, she wanted to know how she could safely work on her singing voice. This is an account of the sixth session. Lynne tells me that she has a problem with the upper part of her range. I can hear that, as she swoops up on a glide, the sound becomes breathy and strained in those upper notes. I wonder at what level she begins to find it difficult. It is always interesting to record this, because, as vocal fold condition and flexibility improve, a singer will report that she can ‘go higher and easier’ up the pitch glide. If we chart the easiest clearest lower note and the easiest clearest highest, we can monitor progress and improvement of the vocal fold structure. I used the piano (but a simple keyboard is equally useful) and found the lowest note that Lynne could comfortably sing. I played this once or twice, and had her intone it on the repeated quick vowel sound oo oo. At this point she was simply feeling her way into finding and making that pitch. As it was quite easy, I asked her to intone a long version of that note, on eeh, aah and ooh. I then asked her to crescendo that note on a long vowel. We gradually moved up the piano note by note, exploring each in turn. ‘Exploring ‘ is a mixture of testing and practising. Of course I always give lots of encouragement to the singer whose voice has been in trouble, because it can feel very vulnerable trying to get notes that you have always taken for granted as being easy. Lynne and I could both clearly hear that her vocal quality got more breathy as she went up her range. I could both watch and hear the way that she was producing the notes, and at several points I noticed that, partly through anxiety, she began to ‘push’. I asked her to stretch, drop over and shake out, yawn, reconnect to the lower breath and make several easy mm sounds. We found that Lynne could reach the A above middle C (A5). She was encouraged that it was higher than she had thought possible, but a long way below the high C6 that she could do before her vocal nodules. Once we had worked up this range a few times, we did some work on moving between the notes, building up to a one octave jump on a vowel. In a very simple way, this is the beginning of mirroring those quick movements between the notes of a song. Sometimes singers are afraid to even try higher pitches, and that guarding can make things worse, because the vocal folds get no practice in changing pitches. Working slowly like this can encourage healthy vocal fold stretching and adjustments. As there is no emphasis on music, words or audience, the singer can focus completely on sound and sensation. The note-by-note approach allows her time to position her vocal folds in the right tension and thinness setting, shape the vocal tract and coordinate everything in the right way with the breath. This takes time. We can suggest techniques but no one can completely tell a singer how to refind her own voice; she has to find this for herself.

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Recommended books Chapman J. (2006). Singing and Teaching: A holistic approach to classical voice. San Diego, SA: Plural Publishing. Harris D. (1998). Singing and therapy. In: Harris T., Harris S., Rubin J.S. and Howard D., eds, The Voice Clinic Handbook. London: Whurr, pp. 207–46. Kayes G. (2004). Singing and the Actor. London: A. & C. Black. McKinney J.C. (1994). Diagnosis and Correction of Vocal Faults. IL: Waveland Press. Miller R. (1986). The Structure of Singing – System and art in vocal technique. New York: Schirmer Books. Thurman L. and Welch G.F., eds (2000). Bodymind and Voice: Foundations of Voice Education, revised edn. Iowa: National Center for Voice and Speech.

Afterword

The description of Sara’s singing to her fretful baby, in Charles Frazier’s wonderful novel, expresses most eloquently the interweaving of body and mind in the deep complexity of the human voice: She sang as if shamed by her own sounds, by the way her life voiced itself aloud. As she began, it seemed that a blockage had set up in her throat. And so the chant that escaped her did so with much effort. The force of air from her chest needed somewhere to go, but finding the jaw set firm and jutted and the mouth clenched against music, it took the far way out and reached expression in high nasal tones that hurt to hear in their own loneliness. The singing carried shrill into the twilight and its tones spoke of despair, resentment, an undertone of panic. Her singing against such resistance seemed to Inman about the bravest thing he had ever witnessed. It was like watching a bitter fight carried out to a costly draw. The sound of her was that of a woman of the previous century living on in the present, that old and weary. Sara was such a child to sound that way. Had she been an old woman who long ago in her youth sang beautifully, one might have said that she had learned to use the diminished nature of her voice to maximum effect, that it was a lesson in how to live with damage, how to make peace with it and use for what it can do. But she was not an old woman. The effect was eerie, troubling. You’d have thought the baby would cry out in distress to hear its mother in such a state, but it did not. It fell asleep in her arms as to a lullaby From Cold Mountain by Charles Frazier (1997)

Voice Work: Art and Science in Changing Voices. Christina Shewell © 2009 Christina Shewell. ISBN: 978-0-470-01992-4

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Appendix I

Organisations and websites These websites were accessed between 1–7 September 2008 The American Speech and Hearing Association (ASHA): www.asha.org Asthma information: www.asthma.org.uk/all_about_asthma The Association Of Teachers Of Singing (UK): www.aotos.co.uk Association of Speech and Language Therapists in Independent Practice (ASLTIP): www. helpwithtalking.com The Australian National Association of Teachers of Singing: www.anats.org.au/aboutus. php The Australian Voice Association: www.australianvoiceassociation.com.au Authentic Movement Institute: www.authenticmovement-usa.com Bone props: www.anniemorrison.co.uk/coaching.htm British Association for Behavioural and Cognitive Psychotherapies: www.babcp.org.uk British Association for Counselling and Psychotherapy: www.bacp.co.uk The British Association for Performing Arts Medicine: www.bapam.org.uk British Voice Association: www.british-voice-association.com Buteyko Breathing: www.buteyko.co.uk Cancer Research UK: www.cancerresearchuk.org Catherine Fitzmaurice Voice work: www.fitzmauricevoice.com The Central School of Speech and Drama: www.cssd.ac.uk Centre for Performance Research, Aberystwyth: www.thecpr.org.uk Chloe Goodchild at The Naked Voice: www.thenakedvoice.com Cicely Berry DVD ‘Where words prevail’ available from: shop.wgbh.org/product/show/ 9583 Disorders of Voice Information: www.voiceproblem.org info Estill Voice Training courses: www.TrainMyVoice.com The European Voice Teachers Association: www.evta-online.org Eva Fraser facial exercises: www.evafraser.com Frankie Armstrong Voice Workshops: www.frankiearmstrong.com The Guildhall School of Music and Drama: www.gsmd.ac.uk Helen Bamber Foundation: www.helenbamber.org International Centre for Voice in London: www.cssd.ac.uk/pages/icv.html

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Appendix I

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International Association for Voice Movement Therapy: www.iavmt.org The International Phonetic Association: www.arts.gla.ac.uk/ipa/ipa.html Laryngograph® Speech Studio: www.laryngograph.com/index.html Lee Silverman Voice Treatment Foundation: www.lsvt.org/main_site.htm Lessac Training and Research Institute (and Lessac Kinesensic Training): www. lessacinstitute.com Linklater voice work: www.kristinlinklater.com Jeanie LoVetri – New York singing teacher: www.thevoiceworkshop.com Larynx models: www.anatomy-resources.com/human-anatomy/sh276.htm, www. espmodels.co.uk Marion Woodman Foundation: www.mwoodmanfoundation.org Massage in schools: www.massageinschoolsassociation.org.uk Medical Foundation for the Care of Victims of Torture: www.TortureCare.org.uk The National Association of Teachers of Singing (US): www.nats.org The National Center for Voice and Speech: www.ncvs.org The National Hollerin’ Contest: www.ibiblio.org/hollerin/hollerin.htm The National Institute of Dramatic Art, Sydney: www.nida.edu.au The Natural Voice Practitioners Network: www.naturalvoice.net NLP Practitioners’ Directory: www.nlp-practitioners.com Osteopath Jacob Lieberman: www.jacob-lieberman.co.uk Physioacoustic chair supplier: www.nextwave.fi/pdf/FA-product_2008.pdf Physio Ed: www.physioedmedical.co.uk Physiotherapy for hyperventilation: www.physiohypervent.org Psychological therapies described on Encarta site: http://encarta.msn.com/encyclopedia_ 761563630_2/Psychotherapy.html The Roy Hart Theatre: www.roy-hart.com The Royal College of Speech and Language Therapists: www.rcslt.org Toning courses at The Bleddfa Centre for the Creative Spirit, Powys, Wales: www. bleddfacentre.com Singing in the management of snoring: www.singingforsnorers.com Singing teachers directory for the UK: www.singing-teachers.co.uk/directory Sound Healers Association in the UK: www.uksoundhealers.co.uk Sound Healers Association in the USA: www.soundhealersassociation.org The Speakers’ Trust: www.speakerstrust.org.uk Speaking Circles: www.speakingcircles.com United Kingdom Council for Psychotherapy: www.psychotherapy.org.uk University of Stuttgart phonetics department – examples of phonation qualities: www.ims. uni-stuttgart.de/phonetik/EGG/page10.htm Vocal Process: www.vocalprocess.co.uk Voicecraft International Pty Ltd: www.voicecraft.com.au Voice Disorder information: www.voiceproblem.org, www.voicemedicine.com The Voice Academy: www.voiceacademy.org (information for the teaching voice) The Voice and Speech Trainers Association (VASTA) in the USA: www.vasta.org The Voice Care Network UK: www.voicecare.org.uk The Voice Foundation: www.voicefoundation.org

Index

Page numbers in italics represent figures, those in bold represent tables. 5RhythmsTM 267–8 Abberton, Evelyn 59 abdominal breathing 81, 86, 120, 129–32, 297–300 abdominal muscles 128–30, 128, 297–8 ultrasound in visualizing 129–30, 135 abnormal voice 5, 14, 95 Accent method 130–1, 305 accessory breathing muscles 127, 134, 135, 143 Acker, Barbara, The Vocal Vision 11 acoustic analysis 356 acoustics 44–5 acting students 462–3 acting training 463–6 acting voice 461–78 actors 4, 68, 461–2 posture training 105–6 voice disorders 466–7 acupuncture 252, 257, 270, 485 Adam’s apple 158 adolescents 117–18 aesthenic 64 age changes 116–20 aikido 265 air traffic controllers 116, 219 alcohol 239, 247 Alexander technique 110, 260–4 alignment 106 head and neck 111–12, 112 alveoli 126 American College of Sports Medicine 27, 28 amplification 147, 160, 181, 198, 206, 452 amplitude 195–6

Voice Work: Art and Science in Changing Voices. Christina Shewell © 2009 Christina Shewell. ISBN: 978-0-470-01992-4

anaesthetic general 39, 219 local 41 analytical approach 16, 17 anger 219 antacids 244 anti-histamines 243 aphonia 415 psychogenic 438–41 Apple Mac exercise 298 Armstrong, Frankie, Well-Tuned Women 11 ‘Arthur the Rat’ reading passage 59 articulation 79, 80, 202, 203–15, 222–3 exercises 377–92 aryepiglottic folds 163, 166, 166 aryepiglottic sphincter 163, 163 arytenoid cartilages 161, 163, 167, 167, 263, 425 aspirin 239–40, 247 assessment 58, 92–3, 490 asthma 240, 247–8 audible nasal escape 155 auditory environment 121 Australian Voice Association (AVA) 12 Authentic Movement 267 autolaryngoscopy 38 back awareness 296 muscles 133–4 background noise 196–7 Bagnall, Alison 115 Baker, Jan 76 balanced onset (voice) 172

516 Index Bamber, Helen 218 Beck, Janet Mackenzie 66 bed, lying in 295 behavioural therapy 234–5 Bernoulli effect 170 Berry, Cicely 465 Your Voice and How to Use It 12 Blaise (Saint) 239 Blake, Ed 129, 269 bleating 194 body 220 exercises 271–92 body language 230, 290–2, 291, 459–60 body position 74, 140–2 body use 110–11 body work 79–80, 258–70 age changes 116–20 environment 120–1 health and physical ability 120 posture 105–13 tension 113–15 tiredness and fatigue 115–16 Boone, Daniel, Is Your Voice Telling on You? 12 brain 22–3, 124, 142 Braund, Margaret 133 breath 74–5, 78, 122–43, 220 control 137–43, 303–5 exercises 293–309 measurement 138–9 muscles 128–35 placing 136–7, 298–300 slowing down 298 support 138 breath holding for effort 123 breathing abdominal 81, 86, 120, 129–32, 297–300 for conversational speech 123 for exercise 123 moving areas 128–35 muscles 126, 127 normal 122 for singing 123 breathing awareness 293–302 breathing in 126 breathing out 127 breathy onset (voice) 172 breathy phonation quality 47, 75, 173 British Association for Performing Arts Medicine (BAPAM) 247 British Voice Association (BVA) 7, 12 bronchodilators 248 bronchus/bronchi 124, 177 Brown, Owen 21 Buffalo Voice Profiles 63

Bunch, Meribeth, Dynamics of the Singing Voice 11 Buteyko method 135, 248 caffeine 240, 248–9 callers (professional voice user group) 448–9 cancer 435, 437 Cape-V 65–6 cardinal vowel chart 207–8, 209 Carding, Paul 42 Casper, Janina 16 CD-audio recorders 62 central breathing 134, 296, 454 central control 296 cerebral palsy 5, 384 cervix 43 chakra breathing 306–7, 306 channel 75, 78, 144–59, 220 changing shape of 146–7 exercises 310–34 opening 294 shapes and settings 143–4 chanting 181 Chapman, Janice, Singing and Teaching Singing 11 children 117, 423 psychogenic aphonia 438–-41 nodules 420 chocolate 240, 249 chronology of voice work 76–9 cigarettes 245, 256–7 cleft palate 5, 6, 155, 417 client rating scales 52 for other practitioners 52–3, 53 clinicians 6, 13, 41, 44, 57, 63, 82, 239, 469 closed phase 45, 46, 47, 170–1, 173–4, 196 coffee 240, 248–9 cognitive-behavioural therapy 234 colds 241, 250–1 cold weather 240–1 CoMeT (Collegium Medicorum Theatri) 13 communication skills 454 consonants 153, 205 constriction, release of 334 contact ulcers 425 cool-down 28, 198, 243, 245, 484 Costello, John 126 coughs 241–2, 250–1 counsellors/counselling/counselling skills 229, 233, 444 counting 300–1, 303 creaking 47, 57, 115, 173, 339, 340 cricoid cartilage 163–4 crico-thyroid membrane 163, 164 cricothyroid muscle 171, 188–9 cricothyroid visor 163–4, 336 cysts 431–2, 432

Index dairy products 246, 251, 472 data 58–60 DAT recording machines 62 decibel 196, 197 decongestants 243, 250, 263 deconstriction 86, 88, 101, 165, 189, 193, 264, 299, 333, 337, 339, 431, 438, 448, 449, 450, 470, 475 diaphragm 131–2 dictaphone 61 diet 242, 251 digital recorders 62 diphthongs 211 diplophonia 434 direct laryngoscopy 39–40 disability 415 disembodied voice 223–4 doctors 6, 13, 38, 44, 57, 63, 82, 231, 239, 469 drama school 471, 472, 478 drama teachers 133 drugs, effects on voice 120 DVDs, recording on 39, 92 dynamic range 488 dysarthria 415 dysphonia 415 muscle tension dysphonia (MTD) 118, 418, 437–8 psychogenic trauma 427–8 spasmodic 434–5 dystonia, laryngeal 434–5 electrolaryngograph 45, 47 emotional environment 121 emotional freedom technique 235 emotional intelligence 229 emotions 205, 216–36, 489 empathy 230 emphasis 200 Enderby, Pam 415 endoscopy 40–2, 43 ENT specialists/surgeons 5, 10, 35, 36, 43, 246, 247, 255, 256, 418, 419 environment 120–1 epiglottis 41, 125, 162–3, 163 epilarynx 163, 163 narrowing of 179–80 equal appearing interval scale 65 Equity (British actors’ union) 462 Estill, Jo 143 Estill Voice Training System 165, 335, 483 European Voice Teachers’ Association (EVTA) 13 eustachian tube 152, 156, 319 Eva Fraser Facial Fitness Centre 148 exercise, physical 148, 242, 251

517

exercises 238, 271–92, 293–309 articulation 377–92 body 271–92 breath 293–309 channel 310–34 group 393–412 loudness 3767–76 phonation 335–45 pitch 356–66 resonance 346–55 experiential approach 16, 17–18 exploratory voice guides 8–9, 11, 15 extension skills 445–6 eye contact 230, 290–2, 291 eye movement desensitisation and reprocessing 235 face 147–8, 147 exercises 310–11 facial muscles 148 false vocal folds 165, 337–8, 339 fatigue general 115–16 vocal 116 feelings 224–5 and posture 272–3, 273 valuing 230 Feldenkrais 270 first impressions 56–7 flexibility (of vocal folds) 29, 88, 189, 253, 356, 419, 491 flexible nasendoscopy/laryngoscopy 39, 41–2 floor work 276–80 fluency 214, 390–1 focus 84, 85, 87, 201, 422, 436, 486 foreign language speakers 209–12, 210–12 formal perceptual voice analysis 57–8, 63–8 formal symptom questionnaires 54–6, 54–5 formants 50, 146–7, 180, 181, 348, 464 forward placing 180 Fourcin, Adrian 44 free movement 266–7 free voice 72–5, 182, 190–1, 226–7 frequency 185 gag reflex 40–1 Garcia, Manuel 38 gargling 242, 251–2 Garrett, Lesley 43 gastro-oesophageal reflux 35 general practitioner (GP) 231 giggle 333, 337, 338, 438 Gildebrand, Katarina 233 globus 157 glottal pops 340 granuloma 425

518 Index gravity 109, 110, 111, 137, 140–1, 149, 244, 263, 264, 277, 281, 398, 399, 404 GRBAS perceptual voice scale – 63–5, 64, 65 Grey, Jane 129 group exercises 393–412 haemorrhage, vocal fold 43, 68, 424 Hampton, Marion, The Vocal Vision 11 handicap 415 hard onset (voice) 172 Harris, Sara 42, 269 healing voice 227–9 health (general) 120 Health Professions Council 6 Hertz (Hz) 185 Hitler, Adolph 448–9 hoarseness 94 hollerin’ contest 199 home environment 120–1 hormones 117, 430 Houseman, Barbara 12 Howard, David 146 humanistic therapy 234 humidity 447 Husler, Frederick 143 hydration 242–3, 252–4, 447 hyoid bone 110, 152, 152, 162 hypernasality 155, 436 hyperventilation 142–3 ideal voice 71–2 imagination 22–3, 305–9 imaging, brain 22–3 impairment 415 implicit memory 29–30 impressions 454 improvisation 226, 343, 355, 393–4, 401, 407–10 incorporation 28–9 India 285, 459 individuality principle 27 infants 116–17 informers (professional voice user group) 450–2 inspiration phonation 337 ‘instant’ exercises 450 intensity (of sound) 195, 196 interjudge reliability 95–6 international phonetic alphabet 207, 208 intonation 29, 57, 75, 85, 87, 115, 117, 120, 190–2, 356, 359, 362, 363, 465, 487 irritable bowel syndrome 151, 425 Jacobsen, Edmund, Progressive Relaxation 259 jaw 149–51 clicking 150–1 dislocation 151

exercises 314–20 joint 149 release 149–50 tension 149–50 test 411 Jones, Daniel 207 Jungian therapy 233 karaoke singing 411, 492–3 karate 265 language 15, 23, 26, 59, 75, 121, 162, 203–5, 206–8, 209, 217, 222, 229, 349, 384, 387, 390, 465, 467 laryngeal dystonia 434–5 laryngeal mirror 38–9 laryngeal models 36, 160 laryngeal ventricle 165 laryngitis 244, 431 Laryngograph Speech Studio 45–50, 46–50 laryngopharynx 125 larynx 110, 111, 125, 157–9, 160–2, 161, 162 cancer 435, 437 constriction 419 endoscopy 40–1, 43 exercises 328–33, 335–6, 339 extrinsic muscles 159 height 159 intrinsic muscles 159, 166, 167 tension 159, 160 laugh 165, 275, 279, 333, 337, 339, 370–1 Laver, John 66 leaders (professional voice user group) 452–60 lecturers 86–8, 451–2 Lehikoinen, Petri 190 length of practice principle 28 Lessac, Arthur 180 Lieberman, Jacob 269 linguistics 58, 216, 219 see also language Linklater, Kristen 12 lips 148–9 exercises 311–14 listening 20–1, 56–68, 229–31 loft register 174–5 loudness 79, 190, 195–202, 222 decibel level 196, 197 exercises 367–76 focus 201 safe 198 variety 200 Loudometer 367–8 LoVetri, Jeanie 8 Lowe, Rachael 129 lungs 125–6

Index lying down position 106, 130, 141, 258, 352, 387, 402, 494 McAllion, Michael 12 MacCurtain, Frances 37 MacKenzie, Morell 38 McKinney, James C., Diagnosis and Correction of Vocal Faults 11 McNaughton, Liz 8 managers 229, 445, 447, 452, 458 manual therapy 269 martial arts 264–6 massage 268–9 maximum phonation duration 139, 139 medulla oblongata 124 minidisk recorder 61–2 monotone 80, 190, 218, 452 mood 224–5 Moses, Paul 219 motivation 24–6 mouth 125 MP3 players 62 mucosal wave 170–1 mucous membranes 165–6, 253 mucus 165–6 muscle relaxation 289–90 muscles 113 of breathing 126, 127 muscle tension dysphonia (MTD) 118, 418, 437–8 music 7, 8, 9, 190–1, 213–15, 218, 227–8, 266–7, 396–7, 479, 483 musical directors 265 musical theatre 7, 13, 224, 372, 416, 462, 463, 479, 480, 481, 483 narrative therapy 235 nasal resonance 179 nasopharynx 125 National Association of Teachers of Singing 8 National Center for Voice and Speech, Denver 13 natural sounds 334 neck 110, 135, 136, 162, 186, 189, 241, 260–2, 275–6, 281–3, 285, 287, 312, 317, 328 alignment 105–6, 111–12, 112, 271, 273–4 negative practice 288 neurogenic voice disorders 435 neuroscience 22, 23, 216, 224, 289 neutral/centred standing 280–1 Newman, Ellen 465 nightingales 197, 197 nodules/nodes 416, 420–3, 421 noise 243, 254–5 background 196–7 classroom 197

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damage to ears 254 effect on voice 196–7 nightclub 254–5 nose/nasal cavities 125 oedema 418 Olbas oil 243, 25 old age 119 older adults 118 onset (voice) balanced 172 breathy 172 hard 172 open phase of vocal fold cycle 40, 166, 169 oropharynx 125 osteopathy 87, 258, 441 osteophytes 157 overload principle 27 oxygen 125, 136, 138, 142 pace 212–13, 388–9 panting 300 papillomas 432–3 paralysed vocal folds 64, 434 paraphrasing 230 pause 213–14, 389–90 Pearson, Jenny, Well-Tuned Women 11 performers 460 personality 3–4, 27, 72, 74–6, 184, 217, 219, 267, 420 Petrucci, Mario 16 pharynx 111, 125, 156–7, 158 exercises 328–33 phonation 46, 71–2, 75, 78, 160–74, 220–1, 496–7 exercises 335–45 phonation duration 139 phonation quality 172–3 phonetics 206 physical ability 120 physical examination 35 physical therapy 269–70 physioacoustic chair 190 physiotherapists 25, 36, 129–30, 137, 143, 157, 246, 269, 298, 495 pitch 48, 75, 79, 184–94, 186, 221–2, 496–7 changing 488 exercises 356–66 extending 358–66 high 189, 190 mean/centre 186–7, 357–8 optimum 187–8 range 49, 190–1, 488 sustained 193 variety 186, 192–3

520 Index pitch work 79–80 poetry 308–9 politicians 200, 454, 457–8 polypoidal corditis 419 polypoidal degeneration 419 polyps 423–4, 424 postural awareness 271–6 postural balance 109–10 posture 105–13 changing 112–13 normal 111 sitting 109, 110 training 105–6 practical voice care 239–57 presbyphonia 119 primal vocal sounds 71, 117 professional voice users 443–4, 447 voice problems in 444–5 see also individual groups progression 28, 76, 77, 101, 238, 260, 277, 393 progressive muscle relaxation 289–90 proprioception 153 prose 308–9 protection strategies 445–6 proton pump inhibitors 244 psyche 4 psychiatrists 232–3 psychoanalysis 233 psychodynamics 233 psychogenic voice disorder 425–30, 438–41 psychological support 232 psychologists 36, 147, 232 psychotherapists 233 psychotherapy 232–3 puberphonia 159, 428–9 puberty 159 public speaking 200, 204–5 Qi Gong 265 quantitative evaluation/ratings 94–5 raised plane position 171 Raphael, Bonnie 143 Received Pronunciation 209, 463 recording 60–1 recording devices 61–3 referral 231, 416–17 reflection 230 reflux 243–4, 255 register 173 falsetto 174 model 173–4 register break 174 Reich, Steve 191

Reinke’s oedema 167, 419 relaxation 259–60 release 21–2, 109, 113–14, 278 reliability 54, 63, 66, 95–6 research 15–16, 22–3, 82, 219, 240, 249, 492 resonance 78–9, 175–83, 221 exercises 346–55 resonance qualities 178 chest 177, 181 head 177, 178–9 oral 180 respiratory system 124–7, 124 reversibility principle 27–8 rhythm 214–15, 391–2 rib reserve breathing 133 ribs 126, 132–3, 295 movement 295–6, 297 rigid endoscopy 39 rigid laryngoscopy 39, 41–2 ring 179–80 Robins, R.H. 58 rock singers 115, 481 Rodenburg, Patsy 4, 12, 123 Rogers, Carl 234 Roth, Gabrielle 267–8 rough phonation quality 75, 172 Royal College of Speech and Language Therapists (RCSLT) 6 Rubin, John 41 salespeople 444 Sataloff, Robert, Professional Voice: The science and art of voice care 11 school teachers see teachers sellers (professional voice user group) 452–60 semi-supine position 141–2, 262–4, 276–8, 277 sensorimotor psychotherapy 235 shoulders 134 loosening 281–2 silence 231, 244, 256, 293–4 singers 76, 80, 84–6, 444 medical care 492 posture training 105–6 singing styles 483 singing teachers 7–8, 10, 15 singing training 480 singing voice 479–97 dynamic range 488 emergency care 491 loss of 480–1 pitch 191–2 quality 487 sensation 487 stamina 487 singing voice disturbance 481–2, 482

Index singing voice specialists 482–3 sitting position 286–7 Sjögren’s syndrome 151 skeleton 106, 107 Skinner, Ann 133 smoking 245, 256–7 sob 333, 493 soft palate 155–6 exercises 325–8 soma 4 sound healing 227–9 sounding 226, 279 space 231 spacers 240, 248 spasmodic dysphonia 434–5 speaking wonderfully 454, 455 specificity principle 27 spectrogram 50 speech and language therapists 10, 206–7 clarity of 206–12 speech sounds 205, 384–8 spine 106–7, 108 curve of 109, 109 flexing 279–80 lengthening 273–6, 274, 275 loosening 282–3 release 109, 278 spiritual leaders 452 squeaking 337 stamina 485–7 steam inhaling 65, 88, 240–3, 245–6, 248, 249–50, 252, 253, 254, 420, 431, 469, 474, 490 Steiner, Rudolph 205 steroids 492 stomach 71, 111, 113, 126, 128–9, 130, 132, 244, 255, 290, 294, 296, 299, 398, 402, 428 strain 197–8 stress 10, 43, 113–14, 135, 137, 150–1, 189, 220, 224, 226, 227, 258–60, 268, 416–17, 420, 425–7, 445, 446, 447, 448, 473, 483 stretches 284–6 stroboscopy 42 subglottic air pressure 138, 196 sulcus 43 support 138 supporters (professional voice user group) 446–8 surgery 43, 154, 189, 193, 244, 256, 419, 424, 431, 433, 435, 476 SVEA (Stockholm Voice Evaluation Approach) 63 sympathetic vibrations 176 synonyms 377 S/Z ratio 140

521

T’ai Chi 258, 265, 284 teachers 10, 95, 444, 451–2 tea tree oil 243 technical skills 201, 466 technique 26–8 telephone marketers 444 television 76, 190, 206, 266, 269, 461, 462 temporomandibular joint 149 tenor voice 31, 72, 80, 145, 191 tension 113–15, 189, 417–25 awareness 287–90 imbalance 115 releasing 113–14, 260, 287–90 text 307 ‘The North Wind and the Sun’ reading passage 59 thin/thick vocal folds 78, 91, 99, 101, 150, 160, 168, 170, 178, 188, 491 throat clearing 28, 101, 165, 241–2, 255–6, 342, 344, 425, 439, 484 Thurburn, Gwynneth 154 thyroarytenoid muscles 188 thyroid cartilage 163, 337 thyroid tilt 188 tidal breathing 141 tiredness 43, 115–16 Titze, Inge 13 tongue 151–4, 152 exercises 321–5 position and tension 152 range of movement 154 sensation 153 setting 110, 153–4 tie 154 toning 226 Towne-Heuer reading passage 60 trachea 125 transgender/transsexual voice 430 transmitters (professional voice user group) 449–50 transnasal fibreoptic laryngoscopy 39 transverse abdominis 129 twang 179–80 upper chest breathing 134–5, 134, 135 upright work 280–4 valves 125, 255, 437 VASTA (Voice and Speech Trainers Association) 7 ventricular folds see false vocal folds vertebrae 106–7, 108 vibrato 193–4 videostroboscopy 42 visualisation 289–90 vocal fatigue 116

522 Index vocal folds 164, 164 closed 40, 170 cysts 431–2, 432 false 165 flexibility 29, 88, 189, 253, 356, 419, 491 haemorrhage 43, 68, 424 internal cell structure 167 length 170–1, 185 movements 166, 167, 168–72, 169 oedema 418 open 40, 166, 170 paralysed 64, 434 position 171 thickness 78, 91, 99, 101, 150, 160, 169, 170, 178, 188, 491 vibration 166, 167, 168, 170, 336, 336 visualisation of 38–40, 39 vocal fry 47, 57, 115, 173 vocal function exercises see exercises Vocal Profile Analysis Scheme (VPAS) 66–8, 67, 192 vocal tract length 36–8, 37, 38 membranes 165–6 physical examination 35 vocologists 13 voice changing 4–5 qualities 4 voice care actors and singers 245–7 emergency 246–7 general 10, 29, 344, 425, 490 practical 23, 239–57 Voice Care Network (UK) (VCN) 12 voice clinics 36 Voicecraft International 115 voice disorders 5–6, 415–42 actors 466–7 functional muscle tension 417–25 psychogenic 425–30 organic 431–7 referral 416—17 Voice Foundation 12 Voice Handicap Index (VHI) 54, 54–5, 437 Voice Impact Profile (VIP) 56 voice onset 171, 488 voice organisations 12–13

see also individual organisations voice practitioner groups 6–9 client options 9–11 voice problems 5–6 voice projection 201–2 voice rest 231, 244, 256 voice skills 71–81 voice skills aspects/parameters 219–23 Voice Skills Framework 83–8, 422–3 singers 486–7 Voice Skills Perceptual Profile (VSPP) 53, 88–92, 172 data inputs 93 interjudge reliability 95–6 personal details 92 quantitative ratings 94–5 recording of assessment 92–3 voice practitioners’ views on 101–2 whole voice ratings 93 voice teachers/voice coaches 6–7, 10, 15, 206 voice therapy 6 voice work continuum 13–16, 14 voicing 224–5 volume 80–1 vowels 205 warm-ups 28 Warner, Sylvia Townsend 198 water, awareness in 295 waveforms 46–50 whole voice ratings 93 Williams C.K. 225 Williams, Jenevora 117 Wirz, Sheila 66 women, centre pitch 187 Woodman, Marion 216, 223 word choice 203 word filling 203 work environment 121 working voice 443–60 xeroradiographs 145, 146, 158 yawning 157, 158 Y-buzz exercise of Lessac 180 yin-yang 19 yodelling 171 yoga 258, 265, 297