Psychogenic Disorders: Finding Your Voice Again with Music

WITHEven speaking at room volume is torture for some people, for others the voice is constantly hoarse, and for some patients not a sound comes out of their lips at all. But not a single doctor could find a clear organic cause for them. “These people often go on an odyssey through the practices behind them,” says Doris Klinger, director of the Vitos Psychosomatics Clinic in Weilmünster, where patients with psychogenic voice disorders are also treated. Speech loss can have many physical causes, such as vocal cord paralysis, laryngeal problems or neurological diseases, as well as psychological causes.

“I couldn’t speak well because I was constantly choking on my own saliva. And I thought correctly, but spoke incorrectly,” recalls patient Renata G. from Weilburg, citing as an example an incident at a gymnastics course she taught. She said that everyone should stand in a circle. She then looked at the participants in surprise as they formed a circle—she really wanted everyone to sit down.

“I almost couldn’t walk anymore”

Months passed and the lively woman who always enjoyed talking, organizing and getting involved fell silent. With the loss of language, social contacts are reduced, and the 70-year-old pensioner becomes lonely. But losing her language is not her biggest problem. She has been suffering from spondylosis, wear and tear of the spine, for many years. She experiences constant pain, and doctors prescribe her increasingly stronger medications.

“I couldn’t walk anymore,” says a woman with short gray hair, looking back. The former competitive swimmer spends most of her time lying in bed and can only walk and stand with a walker. Suffering increases: bright light hurts the eyes, breathing becomes difficult, sleep becomes poor, and the ability to concentrate drops to zero. She requires nursing care and is repeatedly admitted to hospital for pain treatment. Internally, she was done with her life.

That changed last year when G first heard about the connection between pain and psychology. At her request, the neurologist referred her to the Vitos Clinic in Weilmünster. Doctors there are not sure whether to hospitalize the woman. “She was a nurse, she was given a second level of care, we’re not really prepared for that,” says the clinic manager.

What the patient suffering from pain did not know then: The psyche is closely connected not only with pain, but also with the voice. Stress, emotional tension and traumatic experiences can lead to speech problems.

According to Klinger, the Vitos clinic in Weilmünster is one of the few institutions in Germany where these people are treated. The concept consists of several modules adapted to each patient, such as psychotherapy, speech therapy, relaxation exercises and physical training. The clinic, idyllically located in a park on the outskirts of Weilmünster, offers 35 beds for people with psychosomatic problems. “Most of the time, all the seats are filled; we have a waiting list with requests from all over Germany,” says Klinger.

People are caught in a vicious circle

Like Renata G., most people have several symptoms and undergo a detailed medical examination before starting therapy. After all, no one who has organic suffering should be treated with psychotherapy. But many of them have problems with their voice that are purely psychological. The stress of her job as a teacher had affected the previous patient’s voice and she was constantly hoarse. The director of the clinic gives another example: “We had a seventeen-year-old patient who experienced shock and could not speak at all.” Organically, everything was fine with the young woman.