Bridgewater Review

Volume 32 | Issue 1 Article 11

May-2013 Voice as a Parameter of Emotional and Physical Health Ahmed Abdelal Bridgewater State University, [email protected]

Recommended Citation Abdelal, Ahmed (2013). Voice as a Parameter of Emotional and Physical Health. Bridgewater Review, 32(1), 32-34. Available at: http://vc.bridgew.edu/br_rev/vol32/iss1/11

This item is available as part of Virtual Commons, the open-access institutional repository of Bridgewater State University, Bridgewater, Massachusetts. gender), and is encased within a thin, newborns’ crying/vocalization con- typically produce. Let’s take the case When it involves loudness we call it rubbery, flexible and shiny cover called veys pleasure, comfort or hunger. In of laryngitis, for example, which is an shimmer. These tremors are so tiny that the mucosa/lamina propria. Because the conversation, the meaning of utterances infection of the VFs and surrounding neither speakers nor listeners can detect VFs are positioned on top of the airway, may depend solely on intonation. For laryngeal tissue. Like any type of them. When jitter and shimmer values all the air you breathe in and out must example, one can say the word great infection, laryngitis triggers swelling exceed the norms, that could mean PD, pass between them. These two little several times, conveying excitement, as an immune response, which increases a disease characterized by involuntary muscles guard our lives day and night agreement, disappointment or indiffer- vocal-fold size/weight, thus decreasing tremors that eventually affect the entire to ensure that nothing other than air ence simply by modifying intonation. the vibration rate. Vocal-fold body. Because the VFs are extremely gets into the airway. They enable us to Thus, intonation serves fundamental edges become uneven and fail to valve sensitive, PD shows up in them long sneeze, cough, push, or hold our breath social and linguistic communication the air efficiently. The escaping air before it shows up in the extremities whenever we need to. In addition to functions. If speakers do not vary pitch compromises air pressure below the and the rest of the body. Soon a person these life-preserving functions, the and loudness, and monitor their own VFs (which reduces loudness) and adds will be able to call a phone number, VFs enable us to communicate and to voices, speech becomes monotonous. noise to vocal-fold vibration, thus speak for 30 seconds and know if he/ Voice as a Parameter of Emotional add shades of meaning and emotion The listener’s nervous system soon producing hoarseness and reducing she has early symptoms of PD. The to our voices. shifts into habituation mode and ceases loudness further. experimental phase of testing included to respond to the speaker’s voice as it ten thousand people and PD detection and Physical Health Originating from the same location in ignores the unchanging noises of a dish- A 30-second Voice- rate reached 98.6% accuracy. The next the larynx, inside the Adam’s apple, the washer or a fan. Consequently, our abil- based Test to Diagnose phase is to make the system commer- Ahmed M. Abdelal VFs gradually diverge as they course ity to use intonation depends on both cially available to healthcare specialists This article provides basic information about voice and laryngeal health to fellow educators and posteriorly, and each connects into a Parkinson’s Disease (PD) vocal-fold health and voice control. (see http://www.parkinsonsvoice.org/). professional voice users with the hope that it can make a difference in their lives. I tackle voice little pyramidal cartilage (arytenoid) Voice quality reveals important Vocal pathology that alters pitch and from a multi-dimensional approach integrating research and clinical practice. What follows is in back of the larynx. A paired muscle information about vocal-fold health, loudness compromises one’s ability to Smoking and Other based on extensive research that I have reviewed over the years, on coursework that I have attached to the bases of the arytenoids and can alert us to more serious health verbally convey emotions and attitudes. Things From Which You taught in related areas (including anatomy and physiology of speech, language and hearing; rotates them inward to bring the VFs problems. In July 2012, Dr. Max Little Executive control skills enable speak- phonetics, linguistics, and neurological bases of speech, language and hearing) and on my own in contact with each other. Two other and colleagues at MIT adapted voice- Should Protect Your Voice ers to organize their thoughts, and to experience as a licensed speech language pathologist who has diagnosed and treated patients muscles bring the arytenoids more based technology that has been used by Vocal-fold tissue is extremely delicate constantly monitor their own voices with voice disorders for more than 14 years. tightly together to compress the VFs SLPs for decades to design a new test and susceptible to damage. The VFs can and listeners’ body language. against each other. With the VFs now for PD. Normally vibrating VFs tend be harmed by a variety of allergens (e.g., s we move about our daily lives there are sealed, air pressure builds up beneath What Voice Quality to make very tiny involuntary trem- pollen), noxious gases (as those found many things that we take for granted. Voice them and forces the rubbery edges of and Pitch Reveal about ors in pitch and loudness. When the in paint products and some household is one of them. Voice is an extremely intimate the mucosa open, causing the vibration tremor involves pitch we call it jitter. cleaners) and other environmental A we know as voice. Your Health part of our personalities, as it is intricately tied to our There are many voice-quality descrip- Voice as a Vehicle for nervous systems, especially the circuits responsible for tors including pleasant, husky, breathy, Conveying Emotions hoarse, raspy, strangled, strident and grav­ Tips on How to Protect Your Voice and motor execution and emotional processing. For this and Attitudes elly. Voice quality is directly determined Maximize Its Performance by vocal-fold structure and function. • Avoid speaking in noisy situations. This causes you to raise your voice. reason, voice analysis has been widely used in medical A major component of speech is Normal VFs have shiny, moist mucosa the manner in which utterances are • If you suspect you are a loud speaker, get a hearing evaluation. Hearing loss can cause and criminal investigations. Criminal investigators with even, smooth edges. Whether expressed. Normally, speakers depend people to raise their voices. sometimes conduct a voice stress test states, attitudes, agreement or disagree- pitch is high or low depends on vocal- on intonation/melody of speech to to help them determine a suspect’s ment, level of certainly, truthfulness, fold vibration rate per second. The • Avoid tobacco smoke, especially the first-hand kind. add shades of meaning to their utter- credibility. Speech language patholo- deceitfulness, humor, and so on. The greater the vibration rate, the higher the ances. Intonation is achieved by • Space out speaking engagements to avoid putting excessive stress on the VFs, and to gists (SLPs) and ear, nose and throat secret lies in two small, very sensitive pitch, and vice versa. On average, for continuously varying levels of pitch, allow them to rest. doctors (ENTs) conduct voice testing muscles we know as the vocal folds example, a woman’s VFs complete 215 loudness and muscular tension. This to determine if someone has laryngeal (VFs) or vocal cords. vibrations per second, while a man’s • Drink water throughout the day (especially when talking) to ensure adequate vocal- is achieved through constant modifica- pathology. Most recently, voice analysis complete around 125. This explains fold hydration and function. tion of vocal-fold tension and length. has been used as a quick and highly The Vocal Folds Serve why a woman’s pitch is much higher Sometimes intonation is the only tool • Avoid caffeine prior to speaking engagements. Caffeine elevates anxiety and dehy- accurate tool for diagnosing Parkinson’s Life Preservation and than a man’s. These rates, however, used for conveying a message. Children drates the VFs. Disease. We can gather a tremendous are altered in the presence of a cyst, Speech Functions just a few weeks old, for example, learn amount of information about speakers tumor, inflammation, or any mass that • If you experience hoarseness or a gurgly voice while eating, contact an SLP. This could The VFs are positioned within the to use intonation as a means of com- and the messages they are trying to increases vocal-fold weight. A lesion indicate a swallowing disorder. larynx. Each VF ranges from 0.5 to munication. Mothers soon learn what convey through tone of voice. Voice could also compromise loudness and 0.94 of an inch (depending on age and type of pitch accompanying their • If you feel your voice has become less pleasant in tone, seek a voice evaluation. enables us to infer their emotional interfere with the pure tones the VFs

32 Bridgewater Review May 2013 33 gender), and is encased within a thin, newborns’ crying/vocalization con- typically produce. Let’s take the case When it involves loudness we call it rubbery, flexible and shiny cover called veys pleasure, comfort or hunger. In of laryngitis, for example, which is an shimmer. These tremors are so tiny that the mucosa/lamina propria. Because the conversation, the meaning of utterances infection of the VFs and surrounding neither speakers nor listeners can detect VFs are positioned on top of the airway, may depend solely on intonation. For laryngeal tissue. Like any type of them. When jitter and shimmer values all the air you breathe in and out must example, one can say the word great infection, laryngitis triggers swelling exceed the norms, that could mean PD, pass between them. These two little several times, conveying excitement, as an immune response, which increases a disease characterized by involuntary muscles guard our lives day and night agreement, disappointment or indiffer- vocal-fold size/weight, thus decreasing tremors that eventually affect the entire to ensure that nothing other than air ence simply by modifying intonation. the vibration rate. Vocal-fold body. Because the VFs are extremely gets into the airway. They enable us to Thus, intonation serves fundamental edges become uneven and fail to valve sensitive, PD shows up in them long sneeze, cough, push, or hold our breath social and linguistic communication the air efficiently. The escaping air before it shows up in the extremities whenever we need to. In addition to functions. If speakers do not vary pitch compromises air pressure below the and the rest of the body. Soon a person these life-preserving functions, the and loudness, and monitor their own VFs (which reduces loudness) and adds will be able to call a phone number, VFs enable us to communicate and to voices, speech becomes monotonous. noise to vocal-fold vibration, thus speak for 30 seconds and know if he/ Voice as a Parameter of Emotional add shades of meaning and emotion The listener’s nervous system soon producing hoarseness and reducing she has early symptoms of PD. The to our voices. shifts into habituation mode and ceases loudness further. experimental phase of testing included to respond to the speaker’s voice as it ten thousand people and PD detection and Physical Health Originating from the same location in ignores the unchanging noises of a dish- A 30-second Voice- rate reached 98.6% accuracy. The next the larynx, inside the Adam’s apple, the washer or a fan. Consequently, our abil- based Test to Diagnose phase is to make the system commer- Ahmed M. Abdelal VFs gradually diverge as they course ity to use intonation depends on both cially available to healthcare specialists This article provides basic information about voice and laryngeal health to fellow educators and posteriorly, and each connects into a Parkinson’s Disease (PD) vocal-fold health and voice control. (see http://www.parkinsonsvoice.org/). professional voice users with the hope that it can make a difference in their lives. I tackle voice little pyramidal cartilage (arytenoid) Voice quality reveals important Vocal pathology that alters pitch and from a multi-dimensional approach integrating research and clinical practice. What follows is in back of the larynx. A paired muscle information about vocal-fold health, loudness compromises one’s ability to Smoking and Other based on extensive research that I have reviewed over the years, on coursework that I have attached to the bases of the arytenoids and can alert us to more serious health verbally convey emotions and attitudes. Things From Which You taught in related areas (including anatomy and physiology of speech, language and hearing; rotates them inward to bring the VFs problems. In July 2012, Dr. Max Little Executive control skills enable speak- phonetics, linguistics, and neurological bases of speech, language and hearing) and on my own in contact with each other. Two other and colleagues at MIT adapted voice- Should Protect Your Voice ers to organize their thoughts, and to experience as a licensed speech language pathologist who has diagnosed and treated patients muscles bring the arytenoids more based technology that has been used by Vocal-fold tissue is extremely delicate constantly monitor their own voices with voice disorders for more than 14 years. tightly together to compress the VFs SLPs for decades to design a new test and susceptible to damage. The VFs can and listeners’ body language. against each other. With the VFs now for PD. Normally vibrating VFs tend be harmed by a variety of allergens (e.g., s we move about our daily lives there are sealed, air pressure builds up beneath What Voice Quality to make very tiny involuntary trem- pollen), noxious gases (as those found many things that we take for granted. Voice them and forces the rubbery edges of and Pitch Reveal about ors in pitch and loudness. When the in paint products and some household is one of them. Voice is an extremely intimate the mucosa open, causing the vibration tremor involves pitch we call it jitter. cleaners) and other environmental A we know as voice. Your Health part of our personalities, as it is intricately tied to our There are many voice-quality descrip- Voice as a Vehicle for nervous systems, especially the circuits responsible for tors including pleasant, husky, breathy, Conveying Emotions hoarse, raspy, strangled, strident and grav­ Tips on How to Protect Your Voice and motor execution and emotional processing. For this and Attitudes elly. Voice quality is directly determined Maximize Its Performance by vocal-fold structure and function. • Avoid speaking in noisy situations. This causes you to raise your voice. reason, voice analysis has been widely used in medical A major component of speech is Normal VFs have shiny, moist mucosa the manner in which utterances are • If you suspect you are a loud speaker, get a hearing evaluation. Hearing loss can cause and criminal investigations. Criminal investigators with even, smooth edges. Whether expressed. Normally, speakers depend people to raise their voices. sometimes conduct a voice stress test states, attitudes, agreement or disagree- pitch is high or low depends on vocal- on intonation/melody of speech to to help them determine a suspect’s ment, level of certainly, truthfulness, fold vibration rate per second. The • Avoid tobacco smoke, especially the first-hand kind. add shades of meaning to their utter- credibility. Speech language patholo- deceitfulness, humor, and so on. The greater the vibration rate, the higher the ances. Intonation is achieved by • Space out speaking engagements to avoid putting excessive stress on the VFs, and to gists (SLPs) and ear, nose and throat secret lies in two small, very sensitive pitch, and vice versa. On average, for continuously varying levels of pitch, allow them to rest. doctors (ENTs) conduct voice testing muscles we know as the vocal folds example, a woman’s VFs complete 215 loudness and muscular tension. This to determine if someone has laryngeal (VFs) or vocal cords. vibrations per second, while a man’s • Drink water throughout the day (especially when talking) to ensure adequate vocal- is achieved through constant modifica- pathology. Most recently, voice analysis complete around 125. This explains fold hydration and function. tion of vocal-fold tension and length. has been used as a quick and highly The Vocal Folds Serve why a woman’s pitch is much higher Sometimes intonation is the only tool • Avoid caffeine prior to speaking engagements. Caffeine elevates anxiety and dehy- accurate tool for diagnosing Parkinson’s Life Preservation and than a man’s. These rates, however, used for conveying a message. Children drates the VFs. Disease. We can gather a tremendous are altered in the presence of a cyst, Speech Functions just a few weeks old, for example, learn amount of information about speakers tumor, inflammation, or any mass that • If you experience hoarseness or a gurgly voice while eating, contact an SLP. This could The VFs are positioned within the to use intonation as a means of com- and the messages they are trying to increases vocal-fold weight. A lesion indicate a swallowing disorder. larynx. Each VF ranges from 0.5 to munication. Mothers soon learn what convey through tone of voice. Voice could also compromise loudness and 0.94 of an inch (depending on age and type of pitch accompanying their • If you feel your voice has become less pleasant in tone, seek a voice evaluation. enables us to infer their emotional interfere with the pure tones the VFs

32 Bridgewater Review May 2013 33 pollutants. One of the worst vocal-fold of water while speaking. Day after day cups of water per day, while minimiz- White House. So I went up to lunch. offenders is smoking. In the short term, the locations along the edges of the VFs ing/avoiding drinks that dry vocal-fold Voices on Campus When I came in, she stared me down smoking causes frequent episodes of that receive the greatest impact begin mucosa (especially, coffee and alcohol); and started asking me about Watergate. unilateral or bilateral inflammation to form contact ulcers/vocal nodules. If and modifying speaking behavior. Bob Woodward: She blew my mind with what she and thickening of vocal-fold mucosa. excessive speaking occurs infrequently, knew. Her intellectual engagement A condition known as Reinke’s Edema the VFs will be able to heal. However, Impact of Stress, Anxiety What Journalism is About could not be higher. At one point she occurs almost exclusively in smok- if excessive speaking is habitual, the and Other Psychiatric On December 3, 2012, BSU was privileged to host and hear Pulitzer-Prize-winning journal- said I’ve been reading the following ers; therefore, it is sometimes dubbed ulcer soon turns into a painless, perma- Conditions on Voice ist and executive editor of the Washington Post, Bob Woodward, as part of the President’s about Watergate in the Chicago Tribune! smokers’ edema. This condition causes nent callous, and additional tissue will Here she was, scooping it all up. Her The effects of anxiety and stress on Distinguished Speakers Series. Mr. Woodward’s path-breaking reportage about the 1972 a voice to sound guttural and gravelly, build on it and bury it, adding more management style was “mind on, hands the body can be overwhelming, and Watergate incident uncovered criminal conspiracy at the government’s highest levels and led and the person will find it difficult to mass to the VFs. These complications off.” Mind fully engaged in what our their earliest symptoms show up in a to the resignation of President Richard Nixon. With his colleague, Carl Bernstein, Woodward speak out loud. Smoking is linked to cause a significant drop in pitch and job was, but hands off–didn’t tell us person’s voice. These conditions cause set the standard for generations of investigative journalism in the U.S. and opened the eyes of many types of cancer, one of which make it difficult to raise one’s voice. how to report, didn’t tell the editors excessive muscular tension, especially Americans to the concentration of power in the presidency and its potential for corruption. In is laryngeal cancer, which typically Vocal nodules could also be caused by how to edit, what to investigate, what in abdominal, thoracic, laryngeal, the 40 years since, Woodward has had a tremendously productive career as a journalist, editor involves removal of the FVs and larynx, vocal abuse or misuse, caused by speak- not to investigate. lingual and neck muscles. Air in the and political pundit, one that has included the publication of 17 non-fiction books on American and part of the trachea. Another medi- ing loudly, yelling or screaming. Vocal lungs (our fuel for speech) decreases, politics. His Bridgewater talk, excerpted below, outlined the essence of good journalism and At that moment, Nixon was about to which causes shortness of breath during the daunting challenge of getting the story right.– BR go to his second inaugural. He had won talking. The entire larynx is elevated a massive landslide victory over George The experimental phase of testing and constricted, and the VFs are tensed. ow much do we know about what goes on McGovern, winning 60% of the popu- This elevates pitch. Severe anxiety and in politics and among politicians? This is the lar vote and over 500 electoral votes. It included ten thousand people and emotional trauma can induce laryngeal question that plagues journalism. And it is was a wipeout… In addition, in January spasms that may cause a habitual cough, H 1973, one of the secret strategies of the Parkinson’s Disease detection rate a severe asthma attack, or even total so relevant to your lives as citizens. Do we know who Nixon campaign was to get people to voice loss. these people are? Do we know what they actually challenge the FCC television licenses reached 98.6% accuracy. that the Washington Post company These problems can be effectively intend? Once, I asked Al Gore, how much of interest owned. These licenses were very valu- treated by multidisciplinary efforts of or of consequence do we know about what went on in able. The challenges themselves sent the SLP, psychiatrist, ENT and other the stock into the toilet. So, the Post’s cal condition we should protect our misuse can result from habitual abnor- members of the medical team. But the Clinton White House. “You were there for eight stock was in the toilet, its journalists’ voices from is gastro-esophageal reflux mal vocalizing behaviors that strain more important in the short term is years as the Vice President.” This was in 2005, this was reputation was submerged in the toilet disease (GERD), which causes stomach the VFs (e.g., imitating certain cartoon awareness of our vocal health. With and I’m having lunch, with her asking acids to leak into the esophagus during characters/animals). awareness, educators can preserve their five years after they’d left office, after dozens of books, about Watergate. At the end, she had sleep and come in contact with vocal- VFs, avoid the need for medical atten- 24/7 coverage, and two investigations–Whitewater Whether the problem is caused by the killer CEO question: when are we fold mucosa. Untreated GERD could tion and continue to offer our students excessive use, vocal abuse, or mis- and Monica Lewinsky. So how much, what percentage going to find out the whole truth about damage the mucosa, which impacts what they need to hear through the use, see an SLP or an ENT for a voice Watergate? When is it all going to come pitch and loudness. Therefore, you are vehicles of our healthy voices. of the core of what we should know, do we now evaluation. These medical profession- out? I said that because it was a criminal advised to avoid sleep for 1-2 hours als use endoscopy or videostroboscopy know? And he said: “one percent.” conspiracy and all the incentives were after a big meal. to visualize the VFs and make the This is our challenge. What do you of the Post, and she supported the not to talk about it, because when Carl Are You Over-using, appropriate diagnosis. They also use do, as somebody in my business, to get publication of these stories. There was a and I went to visit people at their homes Abusing, or Misusing sound-analysis instruments to measure high-quality, authoritative information lunch she had invited me to, just myself at night, more often than not, they pitch and loudness. Often surgery is of the kind that so often people don’t (Carl had had to go to a funeral) and the slammed the doors in our faces with a Your Voice? required to remove the nodules. Before want you to know? The answer is a managing editor. This was in January real sense of fear, because the Watergate As we speak throughout the day, the the surgery is performed, however, the strong sense of mission and a commit- 1973. We had written these stories five burglars who were caught in the VFs slam against each other thousands person must implement a vocal-hygiene ment to getting it right. saying that there were secret funds and Democratic headquarters were being of times. When a person speaks for program to ensure that the behaviors a massive campaign of political spy- paid for their silence. [Because of all of First, mission. We talk about leadership an extended number of hours, warm that caused the problem are avoided; ing, espionage, sabotage aimed at the these things] I said “never.” She looked Ahmed M. Abdelal is Assistant Professor in and we wonder exactly what it is and air heats and dries vocal-fold mucosa otherwise, the problem will recur. SLPs Democrats, and provided a good deal across the lunch table with a look of the Department of Special Education and what it means. I want to tell a war story and the muscles will fatigue. Voice and ENTs often coordinate their efforts of detail. The big problem was no one pain and bewilderment, and said: Communication Disorders and Coordinator about when I got a glimpse of leader- will become even more strained if the to help patients implement the vocal- believed them. Nixon was too smart. “Never? Don’t tell me never.” I left the of BSU’s BRAIN Network. ship. It… had to do with the Washington speaker does not occasionally take a sip hygiene program prior to surgery. This was inconceivable. You could not lunch a highly motivated employee. Post when we were working on the The typical program involves ongoing have this kind of activity going on in a “Never? Don’t tell me never” was not Watergate story. Katharine Graham vocal-fold hydration by drinking 6-8 president’s re-election committee or his a threat, and this is what was important was the publisher and owner

34 Bridgewater Review May 2013 35