Treatment of psychogenic dysphonia

It is often suspected when a middle-aged patient presents in the clinic with dysphonia or aphonia.

Speech therapy for psychogenic dysphonia is usually very effective. The duration depends on how quickly the diagnosis is made and appropriate treatment is started, and it can range from days to years, depending also on the patient’s awareness of the issue.The techniques most commonly used in these cases are based on attempting to elicit a normal voice, even if it lacks linguistic content. To this end, methods such as coughing, laughing, using falsetto, sirens, phonating while blowing, etc., may be used.Subsequently, the goal is to fill the produced sound with actual linguistic content. It is important that the patient is aware of the progress made and understands they are producing normal sounds. After that, the recovered voice should be trained and exercised.

It is advisable to combine this therapy with psychological and/or psychiatric support.

Aronson refers to a psychological voice therapy, which aims to identify and modify emotional issues associated with vocal problems. He also includes in his therapeutic approach a manual therapy protocol designed to release overloads, which bears his name.

The auditory masking technique is also mentioned in the literature as a way to suppress vocal control in psychogenic dysphonia using the Lombard effect.

It involves reading or speaking while exposed to white noise at 100 dB in both ears. In this way, the patient stops hearing their own voice, loses conscious control, and often shows improvement.

One aspect that has evolved over time is the therapeutic approach to this condition, which now includes laryngeal manipulations performed alongside the sound-based strategies mentioned above. Today, more importance is placed on treating the disorder as a whole.

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Valentina Carlile - Osteopath specializing in Osteopathy for Voice and Speech Disorders since 2002. For information and bookings, visit the Contact page.

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