Application of Alexander Technique to vocal dysphonia...

A client came in this week with severe speech problems.  She gets about two words into a sentence and her voice tightens so much, she can hardly continue.  Her day job is that of an ESL teacher in grades K - 12 in a small town.  She has been struggling with her speech for seven years.

She visited a laryngologist who, in absence of being able to see clearly what was wrong with her, gave her a diagnosis of vocal dysphonia so that she had a legitimate claim for insurance.  She had been going several times a year for the past two years to this laryngologist for botox injections to relieve her symptoms and was desperate to try another way.  Some colleagues of hers suggested she contact me and also the local Speech and Hearing clinic.  The laryngologist agreed that other paths should be looked into.

When I met her, she had already gone to the Speech and Hearing Center and had a scope done.  The scope revealed an interference in her vocal fold activity to the point where her false folds were attempting to take over the process of phonation.  Hmmm...how much can I help here?

Our first lesson together was a chance to take a history (I was especially curious about any type of trauma to her head/neck) and have the beginnings of a discussion about breathing, a choice of first topic that she brought up.  She is a small woman, barely 5 feet tall, sweet and intelligent, and with a lovely openness and self-awareness.  The first things I noticed physically about her was a significant down and forward head position and severe jaw and tongue tension when she tried to speak.  She had an intuition that at least some of her vocal trouble was breathing related.  We clarified the diaphramatic direction of breathing: down on the inhale, up on the exhale.  As her inhale became deeper and her exhale became smoother, we heard immediate improvement in her speech and were encouraged.

We had a second lesson together yesterday.  I checked in with how her breathing practice had gone that week - definitely clearer movement throughout her torso; ribs responding more easily and naturally.  I opened the topic of head/spine relationship and vocal tract shape and structures.  The information on the vocal tract, larynx, etc. was already familiar to her from her doctor visits.  The truly amazing moment came when we began to trace where and how her head rested on the top of her spine.  With a little guidance, she found a better head/spine balance and, suddenly! her voice was flowing freely.  She started to cry in amazement and joy.  She couldn't sustain the new balance for long, some of the supporting muscles were weakened, but by the end of the hour she could  re-find the new balance on her own.  It was the fastest response to the Alexander Technique I had ever seen.