The Voice Keeps The Score
Updated: May 9, 2022
What your voice says about your experiences
We have learned that trauma is not just an event that took place sometime in the past; it is also the imprint left by that experience on mind, brain, and body. This imprint has ongoing consequences for how the human organism manages to survive in the present. Bessel A. van der Kolk, (2014)
It is a curious thing that our body intuitively knows how to keep us alive during times of duress but does not ask our consent. If our body were to tell us that “to survive this traumatic event I will have to shut off all physical feeling, I’m going to revoke your ability to use your voice to convey your feelings — in fact, you may not be able to talk at all, you will find it very difficult to listen and connect with people, you won’t be able to accurately interpret facial expressions, every person you meet may feel like a threat to you, your voice will lose tone and intonation, and similarly, your emotions will become like a tempest, wild and sporadic. There is also no promise you will ever be able to return to who you were before. Do I have your consent?” Your ability to weigh these decisions in the heat of the moment would just take too damn long! And so it comes to the old adage that there is a cost to everything. The cost is, as Dr Van der Kolk suggests, the imprint left on you after the event has subsided not just in memory but in the body. The body goes through many adaptations to keep you alive, that largely go unnoticed; I will for this piece, however, focus on what happens on a vocal level and the adaptions it may make to survive.
Let us go back to understand what the body is doing to survive (How Stress Affects Your Voice explains this in more detail) and how it affects the voice.
The Phylogenetic Hierarchy
Dr. Steven W. Porges, the mind behind the polyvagal theory, revealed that the body descends through an evolutionary hierarchy depending on how we perceive the environment (known as neuroception). Particular interest must be paid to the word perceive because if an external environment in all circumstances is safe the human mind can still perceive it as a threat, social anxiety is an example. There are three levels to this hierarchy.
If one system cannot deal with a life-threatening situation the body descends, to the next, then down to the most primitive system of our biology. The top of the hierarchy exists with the neural exercise of using newer mammalian structures, like the neo-cortex, to inhibit the other primitive systems. It then descends to the next state, the fight-flight response, and then down again to the immobilization or shutdown response, if fight or flight doesn’t work.
The Relaxed State
To a large degree, our bodies and minds are governed by autonomic nervous states. They, in turn, are dictated by how we perceive our environment. If you perceive your environment as friendly and safe the parasympathetic nervous system is dominant and allows for regeneration and most importantly social engagement.
Whilst, the parasympathetic nervous is dominant and the environment is perceived as safe this innervates one of two phylogenetically (fancy word that relates to evolutionary development) more recent vagal pathways called the myelinated vagus nerve that runs from the Nucleus Ambiguus (see figure 1 below) and flows through the soft palate, larynx, pharynx, and down into the heart (important later on). You’ll notice that this nerve runs through all the mechanisms used for speech, and it’s why when you’re relaxed you are usually having a good time with friends. Social engagement feels easy and the bodies around us allow us to self-regulate. Our ability to communicate with such precision and feeling is something that developed over many years and most of these skills are housed within the newer vestiges of the brain like the neo-cortex and nerves such as the one mentioned above. Speaking, for example, is a seriously complex task that involves infinitesimal movements of the larynx, tongue, jaw, pharynx, soft-palate, arytenoid cartilages, vocal folds and the list goes on and on. We can only do this effectively when nerves like the myelinated vagus nerve are firing properly and this can only happen when the parasympathetic nervous system is dominant.
To conclude, the body must be in a relaxed state in order to socialize, communicate, and listen.
Figure 1: Araki, K.; Suzuki, H.; Uno, K.; Tomifuji, M.; Shiotani, A. Gene Therapy for Recurrent Laryngeal Nerve Injury. Genes 2018, 9, 316.
The Fight or Flight State
If a threat occurs and you cannot use higher-order strategies to negotiate it, the body descends to the next autonomic nervous response that we share most commonly with mammals. The parasympathetic nervous system is supplanted by its other half, the sympathetic nervous system. This is the system responsible for triggering the mobilization response and is the reason why your heart beats faster when watching a scary movie. Its job is to prime your body for movement, so muscles are pumped with glucose for extra energy, breathing quickens, and your vocal folds are pulled wide apart to allow for more oxygen to enter the body. It’s why it may be painful to talk when stressed (read Why Your Throat Hurts When You Cry). However, because the higher-order cognitive functions are no longer active, in this state, you are more likely to misread neutral faces as aggressive, the humans around you no longer help you self-regulate as they become a threat to you, and your ability to learn, listen and infer expression from the tone of voice is compromised. For example, young children who live in stressful households perform poorly in school, not because of any lack in their intelligence, but because their ability to self-regulate and brain function is thwarted due to their personal life at home. This state is the domain of anxiety and the unfortunate occurrences of negative feedback-loops.
To conclude, when the body is in an aroused state from having perceived a threat, the ability to create engagement or communicate, listen, and recognize facial and vocal cues are compromised. To bring the body and mind back to higher-order functions, the threat must be negotiated or the body soothed (repeatedly) for the body to acknowledge the passing of threat; think of the importance of a parent’s embrace when a child is in distress or singing a child to sleep with repeated melodies such as a lullaby.
The Immobilisation or Shutdown State
If social engagement and higher-order neural functions, nor fight or flight strategies manage to reduce what the body perceives as life-threatening, the body descends to its state of last defence. Immobilisation, or more accurately, Fear-Induced-Immobilisation. This response is dependent on the oldest branch of the vagus nerve, an unmyelinated portion (the unmyelinated vagus nerve) that originates in the area of the brainstem called the Dorsal Motor Nucleus of the Vagus and is governed not by the Sympathetic Nervous Response but innervated by the Parasympathetic Nervous System. The unmyelinated portion of the vagus nerve is one of the body's most primitive neural vestiges that we share with most vertebrates (S. Porges, 2011).
When this nerve is activated it acts as a “vagal” brake on the heart, slowing it down to a rate slower than the normal resting heartbeat, muscle tone in the face diminishes, sensitivity to human voice further decreases (due to the ears preference for low-frequency sounds and high amplitude noises such as that a predator may make), muscle numbing occurs, vocalization is all but restricted due to a locking of the vocal folds to keep the airways open. Your body does all it needs to conserve energy and keep you alive. Dissociation from pain and the feeling of having an out-of-body experience are common renditions in this state. But why does the body do this?
There is ample enough evidence that “a victim's behaviour can influence the responses of a predator” (Herzog & Bhurgarhdt, 1974). Playing dead, or Tonic Immobility, has its advantages, as shown by some captive predators exclusively eating live food only, and other natural predators have been witnessed ignoring prey in an immobilized state (Sargeant & Eberhardt, 1975). A mouse may just escape its doom from the jaws of a house cat if it manages to stay still for a length of time. The unmyelinated vagus nerve, responsible for the body's immobilization state, which if you recall begins the brainstem, is the same part of the brain we share with reptiles, hence it is referred to as the “reptilian brain” and most reptiles play dead to survive a life-threatening situation. The human body is no different if all other avenues are futile.
To get to the crux of the matter, it is important to note that there are two kinds of Tonic Immobilization. The first is where the body is immobilized not by fear but by biological reflex or hypnotic catalepsy; an example is picking up a puppy or kitten by the scruff of its neck. The other type called Fear-Induced-Immobilisation, as discussed in the last paragraph, requires a certain environmental context like the feeling of entrapment and fear due to this particular emotion being “an important antecedent condition for manipulating [the immobilization] response duration and susceptibility” (Gallup, 1977). The duration of fear-induced immobilization is not only dictated by context and fear, but by the repetition of the event which can have severe consequences on humans; the prevalence of shell-shock in World War 1 is an example.
As animals come out of Tonic Immobilisation, it is natural for them to show “intense and agitated escape reactions accompanied by attack” (Gallum, 1977). However, in humans “the fear of fear and helplessness, and of feeling trapped, can come to dominate a persons life in the form of debilitating shame” and it is such that the stifling of shame, the concealing of overwhelming rage, turns inward and prevents any release from the immobilization response (Levine, 2014). The feelings invoked within the individual trigger the same stress response repeating the effects of immobility and the feeling of shame keeps us revolving within its cycle.
A traumatised individual is literally imprisoned, repeatedly frightened and restrained-by his or her own persistent physiological reactions and by fear of those reactions (Levine, 2014).
Where one cannot escape a life-threatening situation, the body undergoes many adaptations to survive that can become permanent. As it takes proportionally longer and longer to come out of the response, the muscles and mind learn by repetition and time. If the body has learned to round the shoulders to protect the heart, to avoid eye contact, to keep the vocal folds open at all costs, thawing the body to let go of these adaptations that helped you survive but are now making it difficult to live, is exceedingly difficult but not at all impossible. The difficulty lies in the fact that without these habits the body can feel intensely vulnerable, generating fear, which leads back to the shutdown response.
Let me now shed some light on some common changes that may happen to the voice during and after adaptations to trauma and some methods of voice work that coaches and therapists use to aid the body in coming back to a homogenous state. As a final word, it is common that we attack ourselves for these habits we have developed, but if you can, try and see this in another light - your body did what it had too in order to survive and keep you safe, treat it with the same dignity as it has done for you.
Lack of Breath
If there is a lack of breath to support the voice —meaning there isn’t enough breath to finish a sentence, the body may have adapted to a restriction of certain muscles to conserve energy and to physically protect itself like a cacoon. These muscles remained locked as the threat is still perceived by the body and can limit the movement and flexibility of primary breathing muscles such as the diaphragm; tightening of the abdomen in anticipation of danger is an example, except in this case it remains tightened.
These primary breathing muscles require flexibility and relaxation to meet the demands of speech but if the body has kept the remnants of Tonic Immobility the body must recruit secondary breathing muscles to help force the air up the vocal tract to meet the vocal requirement. This is usually identified by noticeable strain and effort in the muscles surrounding the larynx such as the sternocleidomastoids, which are primarily involved in forced inhaling (raising the sternum). The effort required to force air through the vocal tract for speech can become incredibly tiring and typically leads to pain and laryngeal dysphonia.
Many vocal issues begin with how the body is recruiting muscles for breathing; thus, it is common in my field to teach traumatized individuals how to breathe again. Here are, some simple exercises to help reintroduce free-breathing for speech:
Lie on the floor and breathe into your back. Your rib cage should swing outwardly in all directions but in shutdown, this tends to lock to protect the organs. Proceed to only breathe into your back. For this exercise, purposively inhibit the rising of the chest and stomach purely to get an appreciation of the muscles in the back that are being activated. Bit by bit begin to allow the reintroduction of the rising of the chest and the stomach but maintain a consistent focus on the expansion of your back upon the floor. After a couple of deep breaths begin to introduce a vocalized sigh on every out-breath. This is to help retrain the body and mind to connect the feeling of relaxation to speech (the crux of voice work). Perhaps, move onto a vocalized “Aaah” and maintain the sound for a few seconds to introduce sustained phonation.
Next, move your hands underneath your lumbar, and repeat the same exercise. What you’re feeling now is the action of the floating ribs! Even here, your breathing is reinforced by the contraction and expansion of these ribs that are connected to your lumbar spine and diaphragm.
As you move from the floor back to your feet, maintain the sense of your back and speak a couple of sentences. There should be a feeling of ease and elastic recoil as your back and ribs expand. You may also discover new volume, depth, tone, and resonance in your voice! This exercise can be repeated for aiding awareness to your floating ribs, and lateral rib cage.
This is an adaption to protect the jaw and tongue from injury and typically innervates in the anticipation of a threatening event. However, as we have learnt, in the case of trauma or anxiety the feeling of threat remains thus the tightening of the jaw can linger. One of the signals for excessive tension in the jaw is that there is physical contact between the upper and lower molars during periods of rest. You can do a quick check now, if the teeth are clenched together, allow a small space to exist between the teeth; with continued practise, this will gradually help to release the jaw.
A clenching of the jaw can limit resonance, range, and tone in the voice. These are the foundations of what are known as “extra-linguistic cues” (Holzman, P. S., & Rousey, C., 1966). These cues reveal all the other aspects of the body, emotion and physiology that feed into your voice; if this is compromised, how you sound to others may be very different from what you think you sound like, which is why listening to a recording may give you a good idea of the tone of your expression. Listening to a recording can also indicate a clenched jaw if the tone sounds muffled.
Learning to release the jaw can also release a wave of emotion, as you slowly start to innervate the different myelinated vagal portions of the parasympathetic nervous system, which as we know are responsible for the higher-order functions of the brain, self-actualisation and awareness being two of them. Treat this area slowly and with a good deal of kindness and respect.
Anxiety typically results in the tongue pressing firmly against the roof of the mouth, perhaps to keep the tongue free from being bitten by the clamping shut of the jaw. Whatever the cause, a tense tongue can have a wide effect on how you interact, relax and communicate.
A simple exercise you can do now is to have an awareness of where your tongue sits in your mouth currently. If it is pressing firmly against the roof of your mouth allow it to fall, flat and heavy, to the floor of your mouth. It may feel unfamiliar and will take some time to learn but all things take repetition. Take note, that when you breathe your nose, the back of your tongue reaches up to what is known as the soft palate at the back of your mouth and this is a normal activity to maintain airflow through that channel.
Severe roughness or breaks in the voice
This comes from the inability to regulate with precision the delicate muscles within the vocal tract due to the stress responses still being active and withdrawing the vocal folds apart. The secondary muscles for breathing are also innervated to help force airflow through the vocal folds, and as a result, creates tension around the larynx and pharynx, and an imbalance in air pressure which is the cause of breaks in the voice. The pharynx has a large role to play in the roughness of a voice whereas breaks in the voice happen at a vocal fold level. It is almost mind-boggling to know that the most infinitesimal of changes in this channel can have such drastic repercussions on the acoustical sound of your voice; as the very structure of the throat itself determines the formants and harmonics produced by the speaker. The tension of the musculature opens up a whole new set of possibilities that are too many to list here. So, if you’re wondering why your voice goes high when you are excited or stressed, it is because of the changes happening within the vocal tract that is also affected by everything else going on physiologically, like the secondary breathing muscles mentioned earlier. The muscles for speech need the body to work in unison and when you have competing systems at play simultaneously, breaks in the voice are common. The crux of the matter is to truly understand how your body deals with stress or has dealt with it if scenarios, like the above, have become a habit.
There is no quick fix for all vocal issues like the one above but there is a way; it begins with taking some time to understand your body and your habits. The most important facet to remember is whatever your body has done to keep you safe, it did so in looking out for you; so, when it comes time to let go of these habits, as naked as it may seem or the feeling of shame that comes with it, be kind, it did the best it could.
Gallup, G.G. (1977). Tonic Immobility, The Role of Fear and Predation. The Psychological Record, 1, 41–61.
Herzog, H., Burghardt, G. (1974). Prey movement and predatory behaviour of juvenile western yellow-bellied racers, Coluber constrictor Mormon. Herpetologica, 30. 285–289.
Holzman, P. S., & Rousey, C. (1966). The voice as a percept. Journal of Personality and Social Psychology, 4(1), 79–86. https://doi.org/10.1037/h0023518
Levine, P.A. (2010) In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness. U.S: North Atlantic Books
Porges, S.W. (2011). The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-regulation (Norton Series on Interpersonal Neurobiology). NY: W.W. Norton & Company, Inc.
Sargeant, A.B., Eberhardt, L.E. (1975). Death Feigning by Ducks in Response to Predation by Red Foxes (Vulpes fulva). The American Midland Naturalist, 94, 108–119
Van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. New York: Viking.