Performing Voice Therapy

Stigmatisation of voice disorder is heavily influenced by the performance industry’s culture of criticism and induced self-criticism. As a result, singers and professional voice users are primed to blame themselves for voice disorder, instead of regarding it as a natural physical occurrence in the course of their professional lives warranting treatment without any judgement from self or others.

“Vocal abuse”, terminology unique to the international singing community, has regrettably normalised this self-blame issue (Scearce, 2016). In no other field of high-level physical performance is the word ‘abuse’ tied to an injured body part – such as “knee abuse” in connection with footballers’ most common knee injury. Vocal irregularity is, in fact, commonplace for singers at the height of their careers and does not warrant the self-blame and stigma that so often accompanies it.

Unlike all other instruments that are held and played outside the body, the vocal cords and resonators that carry the voice’s sound are within the vocal performer’s body (Helding, 2017). As vocal performers perceive the sound they make differently from anyone in their audience, they rely on a ‘second set of ears’.

This means that their very identity and self-esteem, bound up in their voice, are forged in others’ critique from the outset of their training. This and the fact that private and public assessment through auditions and performance are a lifelong element of the vocal performer’s trajectory, mean that a pernicious culture of self-criticism is rife among already perfectionist-prone vocal artists and other professional voice users.

For singers and other professional voice users, their stage isn’t just a platform where they do their job. It can be a battlefield where they confront their fears and deepest insecurities. Performance anxiety, with its inconvenient physical manifestations (e.g. sweating, shaking hands and body, racing heart or shallow breathing) can become an ever-present companion in their journey. Furthermore, as virtually any vocal problem can negatively impact a vocal performance, health anxiety and performance anxiety are closely related (Sandgren, 2002).

It is vital to distinguish between vocalising (be it speaking or singing), and performing. The skills required for one do not necessarily prepare a person for the other. Performance with its public nature usually brings some fear. Fear can be a useful tool when it doesn’t become crippling anxiety. By learning to notice and harness these feelings of fear rather than being overwhelmed by them, professional voice users can liberate themselves to not only perform to their full potential but enjoy it.

Singers and vocal performers experience what Sandgren (2009) describes as a unique form of health anxiety. Singers have been found to engage in compulsive voice checking behaviour throughout the day (e.g. clearing throat, humming, singing a note) in the absence of actual vocal dysfunction.

Singers’ health anxiety has been found to result in avoidance behaviours such as not using public transport for fear of contracting a cold, or not attending social events in loud environments due to the need to shout. These findings corroborate anecdotal evidence of lives heavily curtailed by the demands of two vocal cords readily exposed to any number of triggers for vocal dysphonia in the daily course of living (Jahn, 2009).

Maintaining vocal health is paramount for singers and professional voice users. However, in the process of battling anxiety-induced illnesses, singers and all professional voice users can find themselves navigating a delicate balance between pushing their professional and artistic limits and protecting their instrument.