Speechlessness: when the human voice falls silent

BERLIN - There are many reasons why a voice might fail such as an infection, overuse or polyps that form on the vocal cords. In most cases, a hoarse voice will recover after a few days but in some people - such as Helga Klein* from Berlin - the symptoms can last for years leaving only enough voice to whisper.

By (DPA)

Published: Mon 11 May 2009, 10:25 AM

Last updated: Thu 2 Apr 2015, 8:45 AM

“It is very unusual to encounter such a long illness,” says the president of Germany’s Society for Speech, Voice and Language Pathology, Professor Rainer Schoenweiler.

Schoenweiler, who is based in the University of Luebeck, says in most cases patients with a chronic voice complaint are cured after nine months and 20 hours of speech therapy. Exceptions to this are cancer patients who normally need years of treatment.

Helga Klein also requires years of medical supervision. She was hit by psychiatric problems and lost the use of her voice. Anxiety and stress in Klein’s job as an estate manager made her so tense that she lost the ability to speak.

Klein says her subconscious deliberately targeted her voice because, “In the past I liked to talk a lot.”

She was treated in Germany’s only acute hospital that deals with voice and speech complaints in Weilmuenster in the state of Hessen. While there her ability to speak returned intermittently.

Much of her therapy was spent with Dorothea Metz-Schneider, the clinic’s psychologist. One of the first questions she asks her patients is, “What would you do if you could talk again properly?” The answer usually is, “I would scream and run about.”

But it is not only the psyche that can affect the voice. Physical, hormonal and neurological problems can also hinder a person’s ability to speak.

Even a slipped disk can cause problems as the human body often becomes tense in response to extreme pain.

The consequences can be wide ranging. A person who has lost full use of their voice may experience knock-on issues at work or they may even be prevented from working at all.

They might also become withdrawn, hardly leave their homes or not answer the telephone. Panic attacks also sometimes follow speechlessness.

Speech problems are often caused by a person’s job. A place of employment where the voice is used a lot can lead to problems in the long term.

In Schoenweiller’s experience, teachers very often fall victim to speechlessness because they work in a very loud environment where they have to be heard above their students. She also includes call centre workers among her patients.

“We are increasingly treating elderly patients,” adds Professor Antionette am Zehnhoff-Dinnesen, president of the German Society of Phoniatrics & Pedaudiology in Muenster.

Over time older people lose the elasticity in their vocal cords as they become less moist. A stroke can also completely prevent a person from speaking.

The vocal cords become hoarse when their complicated system of motion no longer works properly. When we speak our vocal cords vibrate. If the vibrations become irregular, such as when the cords are swollen, our voice sounds hoarse.

A voice sounds breathy and unusually soft when the vocal cords no longer touch each other, which happens during paralysis.

“A hoarse voice is classified as chronic when it lasts longer than three months,” explains Schoenweiler. If your voice is frequently hoarse or is hoarse for an extended period of time, then you should visit an ear, noise and throat specialist.

Many patients also visit a speech therapist for additional treatment. “But if there is a mental problem you should definitely visit a psychologist,” says Zehnhoff-Dinnesen. “Because the voice may return but the patient will develop a gastric ulcer instead.”

Not until a patient visits a speech therapist do they really get to know their voice well. According to Schoenweiller, between one and two per cent of the German population speaks in the wrong pitch. As a result their vocal cords are overworked.

One technique you can use at home to identify your personal voice pitch is to hum a little. If the sound you make while humming is completely different from when you speak, then your vocal cords are probably overworked.

There are several exercises you can do to train your voice. It is also important to keep your voice in good shape. “That includes a number of things such as good abdominal breathing, comfortable clothing and drinking sufficient fluids,” says Schoenweiler.

The patients who are sent to Weilmuenster, however, require more treatment than that. “We deal with the difficult cases here,” says therapist Vera Basquitt.

About 400 patients from around Germany are treated in Weilmuenster every year, most of them stay for six weeks at a time. Their day is packed full of different therapy sessions such as speech training, relaxation training, music and psychotherapy - all of which can help the voice return to full strength. * The name was changed at the request of the interviewee.