Damage Control

When “fixing” a broken voice, a lot is involved. Even very skilled, experienced singers can find themselves in situations where the voice doesn’t do what it should, but the vocal folds are healthy. I have worked with several very skilled vocalists, some with noted careers, who have had something called “Muscle Tension Dysphonia” (MTD). The diagnosis means that the vocal folds are not phonating (making sound) properly, due to some kind of straining or squeezing. In my opinion, this is what happened to Callas, gradually, over time, toward the end of her singing career, and why you can hear that it took greater and greater effort for her to sing on pitch, especially in high notes. I think this is why, in the end, she was forced to stop singing completely.

No one knows why MTD occurs, or what is happening. Speech Language Pathologists (SLP) can’t deal with it in terms of singing unless they also are singing teachers (and some are, but most are not) who have experience working with this issue. The most common problem with MTD is that the singer can’t sing the pitch they are hearing. This can be slight, meaning that the singer might just be flat, or severe, meaning that they cannot make the pitch at all. This does not have anything to do with “breath support” and it cannot be fixed by changing the breathing, and although poor breathing and posture doesn’t help, they are not the source of the dysfunction. None of the singers I have seen had any issues with posture or breathing, having had lots of training and professional experience. It doesn’t have to do with jaw tension or external tension, although these areas can become involved if the problem is left unaddressed, as it can cause tension to spread. It has to do with internal tension within the throat itself. The tension is usually not felt as such, as it is “buried” deep within the internal vocal musculature. Sometimes, if the person just stops singing, it goes away on its own, but if the singer has reasons to perform…..gigs, contracts, etc., or a family to support, stopping isn’t so easy. People will struggle to go on, if at all possible.

In the past we referred to this as someone “losing their voice”. It isn’t the only reason why someone who is experienced and skilled speaks normally but can’t sing. It is not, however, just “mental” or “psychological”, although the singer can assume there is “something wrong with them”. Even some throat specialists don’t necessarily understand this issue as one that is a diagnosed medical condition that professional singers can develop.

Working with a professional singer who has MTD is tricky. Fortunately, everyone who has worked with me has recovered their ability to sing. I developed my technique to work with this on my own, and I cannot explain why what I do helps. It uses a combination of approaches and can take time. Even if the singer is diligently practicing, muscles that are “locked” take time to unwind, given that the singer was probably not aware that something was getting tight in the first place. There may be a significant emotional component involved in this situation, but certainly losing one’s ability to sing (but not speak) can be a cause of emotional distress, so it is hard to know if the emotions are the source of the problem or the result of it.

Working with a singer who has severe technical problems isn’t so far from working with someone who has MTD. Singers who come in with wide vibratos, uncontrolled breathiness, big register breaks. etc., are experiencing vocal muscle distortion. Sometimes this is CAUSED by training. Teachers who ignore changes in singers’ vocal output (especially young ones) and do not note these issues as being incorrect vocal response from the mechanism, are irresponsible teachers. Singers who develop these problems may not notice them, or may not have the resources to know how to fix these behaviors without assistance.

The only formal training for singing teachers is in Vocal Pedagogy courses, which are aimed at students in Masters’ or Doctoral Programs for CLASSICAL singing only, [there are NO Masters or Doctoral programs in CCM or Music Theater Vocal Pedagogy anywhere except for my program at the CCM Institute at Shenandoah Conservatory, which offers credit at the masters level]. The few Vocology internships don’t exactly cover this topic, either, so it isn’t surprising that singers and teachers generally have no way to work with MTD or severe technical problems, especially in CCM singers, except if they “fall into” something that works, as I did. There are many more teachers who have not taken such Vocal Pedagogy/Vocology programs than those that have. And even those that have a degree in Classical Vocal Pedagogy (still quite rare) are not trained to work with MTD in a singer, but are rather asked to be knowledgable about the various “schools” of vocal training and their philosophies. Speech Language Pathology doesn’t offer much training in voice, and being a SLP who specializes in working with professional voice users is also rare. Being such a person who also sings various styles of music and understands them from personal experience is beyond rare……..I can think of only a handful, and I know LOTS of people in voice care in many disciplines all over the world.

This is one more area where there is so much need for knowledge to be shared. Perhaps we need to start a database for addressing MTD and severe technical problems so that singing teachers can have this as a resource. It’s a thought.

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One thought on “Damage Control”

  1. When I read this blog, I am reminded that I am one of the very few ‘specialized teachers’, and its such a shame. I hold a PhD in Vocal Physiology and Speech Path. I majored in The Professional Voice User, and only work with singers. Ironically, I am dealing with MTD on a weekly basis, and find it very trialing. Re-training the intrinsic/extrinsic musculature of the voice is quite tricky… and indeed only a specialist of some form would know how to tackle it. Changing ‘muscle memory’ in a singer is a relatively long process, especially when the don’t apply what they have learned in their day to day lives. VERY common!)I constantly find a client/student walk out of a session with me, and then refuse to apply correct vocal hygiene, yell over music in loud bars, and then answer the phone all day as their job!) I think the idea of starting a data base to help singing teachers understand MTD with links and options to learn how to correct it – is a brilliant idea. I also cannot stress enough the importance of Manual Laryngeal Massage during the rehabilitation process.. It really does help dramatically. This is yet again another tool that is excellent, and yet no teachers can apply it. Of course you must be trained to apply it, but I really think these resources should be readily available to ALL teachers of singing. In reality, these two worlds are completely separated… the ‘Vocal Technician/Physiologist’, and the ‘Voice Teacher’ – and I really think its time they integrated.
    If I can assist in any way to add to a data base, I would jump to it! There should be so much more accessible education for the singing teacher, in particular courses and resources for teachers dealing with rehabilitating the SINGING voice. Indeed, I am all for it!
    Even I am still constantly learning, and to be honest, I could do with a data base too!

    Amber D.

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