Two-Thirds of Americans Live With Voice Disorders

About two-thirds of Americans experience voice problems daily.

March 8, 2011, 6:33 PM

March 10, 2011— -- Sarah Palin and Hillary Clinton may be miles apart in their opinions about how to deal with the Middle East crisis ,but they do have one thing in common: They both live with something called cheerleader's voice syndrome.

When Clinton fires off a verbal warning to the likes of Muammar Gaddafi, she tries to project authority and confidence, but instead her vocal cords rub together too forcefully and create a sound that's abnormally tense and grating. And when Palin shouts "Drill baby drill!" it comes across as shrill baby shrill.

Few would argue with these bipartisan auditory observations.

"Cheerleader's voice syndrome is just one of the many voice problems American's suffer from," said Russian-born opera singer turned voice coach Elena Zoubareva, who, with the help of a Harvard ears, nose and throat specialist and speech language pathologist, has developed a new voice training program called FitVoice.

Zoubareva said that about two-thirds of Americans -- more than 28 million people -- experience voice problems daily. The damaged voice boxes of schoolteachers alone cost American taxpayers $2.5 billion in missed workdays each year.

To Zoubareva's ear, women are usually worse offenders than men. "Many women speak like this," she said, dropping her voice several throaty octaves to verbally illustrate her point. "They sound from the chest and there is a tendency to speak lower than their optimum pitch level."

The reason for this, Zoubareva speculated, is that consciously or subconsciously, women believe lower tones are sexier and will get them noticed more in business and by the opposite sex. Like the squeaky cheerleaders, those with this so-called Bogart Bacall syndrome are also trying to exude more confidence, strength and authority. Think of Lauren Bacall, the syndrome's namesake, as the worst-case scenario.

"In the beginning, Bacall had a much higher, normal sounding voice," Zoubareva said. "But somewhere along the line she was probably advised by a director or producer to try to sound sexier, and so she learned to lower her voice quite a bit."

Men have diction friction too

For their troubles, both groups of women are often rewarded with nodules, which form like calluses on the vocal cords. These can eventually harden and scar to produce a permanently hoarse, strained speaking voice.

Lest men feel smug about their sonorous superiority, they should be reminded of their own special brand of phonotraumatic habits. Zoubareva identified a problem she dubbed sports fans voice, acquired after years of listening to the Red Sox fans in her adopted hometown of Boston scream themselves into a voiceless frenzy by the end of every game. All that unfettered shouting and cheering can lead to the growth of polyps on the vocal folds, which can so damage the voice, that they might require surgical repair.

The poster child for this syndrome is Steven Tyler, Aerosmith's frontman and lately the "voice" of American Idol -- so to speak. Hitting all the rock and roll high notes and all the lows of a rock star lifestyle beat up his vocal cords to such an extent that they ruptured and started to bleed. Fortunately, with surgery, rest and retraining, he recovered his vocal instrument. A recent National Geographic documentary included close-ups of his vocal folds vibrating together, like Eric Clapton's guitar strings as he reached and held the signature notes of "Dream On."

Then there is Bill, Hillary's husband and former leader of the free world, with his perpetually hoarse and weakened voice. Though Zoubareva has never met him, she suspects Clinton may have acid reflux, a stomach problem in which churning gastric acids perpetually creep up into the throat causing burning and inflammation. Zoubareva has observed that Clinton adds to his voice distress by clearing his throat a lot and not breathing properly.

Enduring hoarseness is very common in American speakers, Zoubareva explained. Besides acid reflux, it can be caused a number of other factors. Talk show host Rachel Ray, for instance, has publically stated that her chronically scratchy voice is the result of vocal cysts.

The aptly named Dr. Phillip Song, Zoubareva's medical collaborator, said that many Americans are prone to voicing everything from their opinions about health care reform to the latest on the weather with what speech experts call a hard glottal attack.

Voice is produced by three subsystems: the lungs, which provide the air for breath; the larynx or voice box, which houses the vocal cords that vibrate like string instruments to produce vocal sounds; and the oral nasal cavities, where the sounds resonate before they travel to the listener's ear.

Speakers with a hard glottal attack pronounce vowel sounds too severely because they expel too much air from the lungs and slam shut the space between the vocal cords known as the glottis with too much force. "The result is talking in a loud, harsh, stiff way. It's an abusive voice pattern which over time causes trauma to the vocal folds," Song said.

The worst offenders, both Song and Zoubareva agree, are Northerners with their discordant nasal honks and propensity to speak too loudly, too rapidly and too often. Over time, this forceful, repetitive impact on the aspects of the larynx can cause irritation and long-term voice disorders. As Song said, "The more you use the voice, the more you abuse it."

Keiko Ishikawa, the speech language pathologist from Massachusetts Eye and Ear Infirmary who consulted on FitVoice, said that Southern belles are the most likely American speakers to have the singsong, melodious voices with the fluid qualities preferred by most speech experts. "They often have a sweet, smooth way of talking, which doesn't have quite so much of a hard glottal attack," she said.

However, Song pointed out there is no evidence that Northerners are any more susceptible to voice problems than citizens of the South. He suspects difficulties are probably evenly spread throughout the country. And Americans may not be the only culture to mount the hard glottal attack. However, since vocal medicine is a relatively nascent field, Song said no global survey has yet mapped out verbal stylings from country to country.

Tips for soothing your voice

Zoubareva also believes that lifestyle habits, such as diet, exercise and smoking, can have a great influence on voice quality. She believes that President Obama's past smoking habits could account for his voice, which, while pleasant with nice tones, doesn't come close to stacking up against FDR's oratory perfection.

As part of her FitVoice program, Zoubareva shows sports fans how to cheer on their favorite teams without trashing their vocal cords. She drills them on a series of vocal training exercises similar to those used by professional opera singers and teaches them how to project their voices without trying too hard. She recommends seeking this sort of training if you experience voice issues. "Getting help doesn't occur to most people either because they aren't aware there is anything they can do or because they assume the voice problems will go away on their own."

Certainly everyone can practice simple voice maintenance by drinking plenty of water and limiting caffeinated drinks to ensure the voice box stays well hydrated. Zoubareva prefers liquids at room temperature because extreme temperatures may shock the vocal cords. It's also important to breathe correctly, sit up straight and scan the body for signs of stress and tension, especially in the neck, jaw and tongue. She also warns against clearing your throat because it causes irritation. She said, "Instead you should swallow hard and drink water as soon as possible."

Who knows? With proper training and good vocal hygiene, you might be able to cultivate the high quality tones of, say, Meryl Streep or Robin Williams, two of Zoubareva's favorite American celebrity voices. At least you won't sound like Charlie Sheen.

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