Psychogenic Voice Disorders

Psychogenic voice disorders are caused by psychological issues, such as a traumatic event. These disorders include dysphonia, an impaired or disordered voice, or aphonia, a condition in which a person is unable to speak. Psychogenic voice disorders can be treated with a combination of psychotherapy and speech and language therapy.

Diagnosis

• Psychogenic voice disorders are as real as disorders with a physical cause. The patient is unable to speak clearly or might be totally mute. In order to diagnose psychogenic voice disorder, an otorhinolaryngologist--a physician who specializes in voice disorders--would first examine the patient and determine whether there is an organic cause for the problem. If not, then a psychological evaluation would be necessary to reach a diagnosis of psychogenic voice disorder.

Types

• There are two main types of psychogenic voice disorders: dysphonia and aphonia.
  Dysphonia is characterized by intermittent, involuntary tightening or constriction of the larynx. A person's voice with dysphonia sounds labored, wheezy or constricted. Aphonia is the inability to speak at all. While most cases of dysphonia and aphonia are not psychogenic in origin, some are.

Causes

• The causes of psychogenic voice disorder can be a single traumatic event, such as a rape, or living through a long-term stressful situation. According to "Understanding and Treating Psychogenic Voice Disorder: A CBT Framework," several underlying situations can lead to this disorder. Family and personal difficulties, difficulty expressing views and emotions, a tendency toward suppressing anger and frustration, and feelings of overcommitment and helplessness are risk factors. A person who feels unable to speak up about the problems and injustices in her life might one day find herself truly unable to speak. This is a disorder that affects females more frequently than males by a ratio of 8-1.

Social Causes

• There is sometimes a cost to speaking out, and people afflicted with psychogenic voice disorders might have correctly discerned that they were not living in a situation where it was safe to use their voices. The best chance for recovery will occur when the patient is living in a supportive environment where speaking out will not result in punishment or isolation.

Treatment

• Psychogenic voice disorders are treated with a combination of speech therapy and psychotherapy. If the causes that led to the speech disorder have been successfully resolved, the main emphasis of treatment will be for the speech language pathologist to help the patient relearn functional speech habits. For the patient whose trauma has never been discussed or resolved, the most effective treatment will rely heavily on psychotherapy to help unearth and deal with the event that led to the loss of voice.