"Voice Rehab"

"The wound is the place where the light enters" Rumi

I saw an old friend last night who had been seeing the limitations of themselves in relation to their injury. We do this. We limit ourselves. What happens when we are no longer able to do the things we were doing effortlessly and pain-free before? How can we not be hard on ourselves or punish ourselves, or as my lovely friend Sara says 'let ourselves off the hook'. Why is injury judged and what makes one judge it?

I had an accident back in June, and suffered whiplash (not for the first time either), with ongoing treatment being required. How may we work ourselves out of an injury? So many questions spring to mind. Is it easier if we have a high level of technical knowledge pre injury? Does it make it harder or easier if we have awareness about what is happening to us?  Where does our fear sit when we have an injury? Do we go into fear at all or is it all encompassing? If we know more what might go wrong, how difficult is it to surrender and allow healing and recovery to take place? How can we move out of the emotions that might be overwhelming, and move to a place of acceptance? What we know is that when we focus our intention upon the present and plan for the future that lies ahead, with all its unknown qualities, it leads to an easier path.

As a Speech Pathologist, my role is mulitfarious in terms of recovering the injured voice.  I create structures and guidelines (often quite strict) for my clients in order for them to rehabilitate vocally. Not to whisper, shout, sing, or in some instances talk much at all, depending upon the injury or infection. It is a big ask for someone to stop speaking, or at least, speaking as much as they used to. To stop singing, even for a short time, can feel as if someone is asking them to be one handed. Often as an explanation, in our voice clinic, we use the analogy of a vocal athlete. It is a wonderful analogy, so much so I created a business from this model www.vocalathletics.com Singers and other professional voice users are our vocal athletes. The opera singer sings a marathon night after night. (Wagner may be a double marathon!) But so is the local school teacher who runs the equivalent of 25km a day!

We usually don't think twice about an AFL footballer or elite sportsperson doing a "corky" or a "hammy" or sustaining an injury, especially at the elite level. In some ways we almost expect that this might happen. Post injury, these sport players get elite and frequent rehabilitation.The media reports on it (as a general rule) without punishment or blame and gives regular updates on how players are recovering. Not so, it seems, with elite singers. The recent surgeries of the likes of Adele and John Mayer received less coverage. We don't know who their surgeons were (unless we look extensively on the web), or what their rehabilitation was like. I could not find out who their Speech Pathologists were. It seems enshrouded in secrecy, as if these voice difficulties are best hidden. At the other extreme, such as in the case of Julie Andrews, negative publicity was generated because of her poor voice outcome. She later teamed up with those same surgeons in an effort to promote their work and raise awareness of these issues surrounding the voice.

Most of my clients, particularly those from the media or international/national singers do not want to be known to have had "Speech/ voice therapy". Obviously,  I respect their privacy fully, as it seems that they feel that they too may be judged from this. If they had a personal trainer to get a great physique, we would know about it, I am sure.

I speak highly on both a personal and professional level of the amazing specialist voice physio Annie Strauch of Performance Medicine Physiotherapy. A sports physio for the vocal athlete! Is neck tension and a tired larynx something to be ashamed of? I do not always think so, especially if our technique is good. Is it because they think they have done something wrong? Does an AFL player blame themself for their injury(ies)?  I do hope that this attitude is one that will change in future years, and that voice rehabilitation is not something to b ashamed of. The more awareness we have of the voice and how we can look after it well, the better, in my opinion. We are not flawless human beings with flawless medical histories.

So. look after your precious voice: "You don't know what you've got till its gone...they paved paradise and put up a parking lot" Joni Mitchell

With voice injuries, I always suggest that a sound structure goes a long way- an email outlining what has been happening (usually a set of 3-4 varied emails depending upon who the recipients are) as well as a voice message on phones (recorded by them or somebody else) that suggests an sms or email is the preferred as a way of contacting them whilst they are having difficulty. This does help to take some of the pressure off the repetitive nature of retelling the story and the injury. Could we imagine the person with the "hammy" standing up and re-enacting the dreaded scene and showing us the same pose that they were in when they were injured. No. No, I think not. Yet the voice is perceived as different. It is of course, and yet also needs some of the same treatment.  

In terms of "real life", others judgement and concern certainly happens quickly. The questions usually come when they least want them; scuttling out to get milk and the cashier says- "oh, what is wrong with your voice, you should really get that checked out. You sound dreadful". Or friends who are wanting to be supportive and want to talk all the time with them. How do we say what is in our hearts when we are not able to use our speaking voice? How can we do it especially if we have not addressed the important emotional aspects of the recovery. What if we want to cry or yell in frustration every time we go to open our mouths? Can we do our job silently? Do we have 10 jobs that we are juggling? How do we make money? Most jobs these days require that we use our voice. Would you be able to perform your job duties if you had to be minimally speaking? How do we find that elusive patience and mindfulness in the midst of this process to really know it is a process and not focus on the immediate outcome. So many questions also means that people feel that their lives are no longer in their control, and it is an interesting and sometimes unfamiliar place to be.

Voice rest is a controversial issue currently. How long should we not make sound for if we have had an injury (or lost the voice?) What if we misused it on a night out and sang too much karaoke? How much rest would we need then? There are many factors for us to consider, and it is usually recommended on an individual basis. And for those for whom surgery is indicated, how long post surgery should one be completely silent for? As yet, we do not have the definitive answers according to the evidence, however it is becoming clearer as time and research continues. A Speech Pathologist and a Specialist ENT have some up to date answers on this. Unfortunately I have seen too many people who were advised voice rest (of up to one month) with no follow up specialist referral when they had a serious injury. Time lost in the most important part of the process, so that recovery can occur in a timely manner. 

And as my Nan used to say "A stitch in time saves nine." So if you are not sure about your voice, and it has been niggling at times, or you have had unexplained voice loss, croakiness, soreness and trouble talking perhaps it is a wise choice to book in with someone who knows. And I mean really knows. Not the "my friend who is an occasional singer told me that......" An excellent voice coach or a Speech Pathologist who has extensive experience with voice is a good place to start. We may think we have excellent vocal technique, however sometimes this is far from the truth. And our voices are important to us. Often only found out when it gives us trouble. We also can learn from when it is not feeling good. We can then take steps to care for it. and find the easier path to great and fabulous "shibumi" voicing!

Secrets of the voice

"The muse opens the throat and enables you to speak...It was so believed that the existence of things was not complete unless there was a voice to express it"  Helen Todd, Voice Coach.

A beautiful friend of mine, Catherine, sent me the book "Secrets"by various authors. In it is a novella called "The clear voice suddenly singing" by Amanda Lohrey. May I also say how wonderful it is to receive mail in the post. Such a delight to be so remembered in such a fashion. She had said that when she had read it, she had thought immediately of me.

"The clear voice suddenly singing"brought me to tears on first reading. The portrayal of the power of the voice, as well as how voice teachers can facilitate this connection to our own voice resonated immensely with me. "Some days my voice is so big it scares me". I too have made sounds that seem so enormous that it has made my whole body shake and tremble, almost as if it was going to explode like a fountain. Some of us use our voice in such a way when we are angry, or "seeing red" where our voice seems to take on a completely different timbre and open capacity (possibly to the detriment of those who may be in the vicinity).

It speaks of those who have not always had a voice, both metaphorically and physically; how they have searched to find their voice. This makes up a good deal of my client population. From the "little girl voice" and transitioning to a much larger vocal realm. It is a shift on many levels for people to get reacquainted with their voices. And the immense power we have when we communicate to another.
I regularly see with my clients who stutter, that upon improving, they sometimes do not know how to keep conversations flowing. It had been such an effort to expel even the basics of information that conversation for it's own sake is seen as true luxury: like the Queen Jewels, something they could not possess them themselves and looking at others with a mixture of envy and resentment. "How do they do it?" Indeed how do we. And why do we do it? What makes us do it?

Lohrey speaks of the muse in relation to the Greek myths. How we all need to have a muse. How this can be part of our song. "The singer experiences inner life as something (they) share with the world, not as something that sets him apart from it". (Stephen Schafer) So how do we find our song. The one that is uniquely ours. How do we find our own voice, the subtle, rich and glorious realms of our voice. Often I say to clients, that I do not wish them suddenly to be an extrovert, but that they may become comfortable with saying whatever it is they want to say, powerfully and persuasively, standing in what is true for them.

One of the other "secrets" is the discovery of how complex the voice is. Whoever has stood next to a flailing shower curtain knows how the curtain wants to stick to you, and that is the same way the vocal  cords connecting happens: The Bernoulli effect!

In the modern day of Reality Idol programs and such, there are many who think they can sing. Often, however they lack the appropriate technique that will carry them through big sings, 8 shows a week, concert after concert. "In some ways being a singer is like being an athlete: both are external expressions of who you are" (cited from Lohrey's novella) When I started Vocal Athletics in 2007 I had seen the voice as an athletic structure: an opera being like a marathon. How we take the voice to the highest realms and stay there. Prevent injury. Feel good. 

To be an excellent athlete, we need many factors: external and internal physicality, mentality, emotional strength and flexibility and faith in ourselves. There is a "Singer Personality Profile" which is interesting indeed (another time, perhaps). In 'The science of breath" by Yogi Ramacharaka he states that in the West we are paying a great deal of attention to the external muscles. "But in their enthusiasm, they must not forget that the exercise of the external muscles is not everything. The internal organs also need exercise". 

Breathwork, and singing provide excellent internal work. Our pelvic muscles can be "fit" with the breath and singing. The Transverse Abdominus (TA) is vital for supporting the breath for singing, as well as speech. We know when they are working if we have had such a big belly laugh that all our insides ache. Athletic on the inside and outside. I have seen many women who have had gynaecological issues or injuries as well as men who have had prostate difficulties present with reduced breath into this area. (Not always the only reason, of course) And hence, not as vocally powerful as they would like to be.

Often retraining the breath into this area and using the core muscles again can have a dramatic impact upon the quality of the voice, as well as the quality of the breath. An idea of toning the organs, likening it to an internal massage. One such client  had had an emergency Caesarian many, many years before, and had never breathed "down there" (her words) since.  With gentle physical and verbal encouragement, the breath fluttered gently into her lower belly, and so too did her tears. Her voice found a deeper resonance with less strain for the breath was able to reside in more of her. Interestingly too she had had stomach troubles since the Caesar: a sort of internal holding of the musculature.

Many speak of using the singing voice as a healing modality. That voice resonates where words cannot. It allows us to access that aspect of us which is primal and pre-verbal. A place where we can breathe easily. New born babies do this effortlessly: make sound, move, roll, breathe. And perhaps that is indeed the secret. How can we re-find that effortless aspect of ourselves? For there true athleticism, movement, flexibility, strength, endurance and freedom is likely to reside. 

xx