J. Pahn and E. Pahn30

Education and treatment of the speaking and singingvoice according to the Nasality MethodJ. Pahn and E. Pahn

From the Universitat Rostock, Medizinische Fakultat, HNO-Klinik, ‘Otto Komer’ Abteilung Phoniatrie-Padaudiologie, Rostock,Germany

Log Phon Vocol 1998; 23 (Suppl 1): 30–32

The term ‘‘nasalizing method’’ embraces a voice training procedure for the therapy of voice disorder and vocalization. The trainingmeasures differ as to etiology and pathogenesis of the disorders. For this reason, diagnostic terms are introduced which correspond to thedifferent aims of training therapeutics. Among the methodical guidelines, such as economical use of the voice function, instrumentality ofthe voice function, therapy concept, the method comprises seven focal points. The practical training measures are subject to principleswhich lead to a wide scope of variation, so that there is a distinct difference in the course of treatment for each voice disorder and eachindividual patient.

Key words: speaking and singing voice, therapy, training, vocalization, nasalization.

Professor Johannes Pahn, Swolkenweg 9, DE-18146 Rostock, Germany. Tel: +49 381 443048; Fax: +49 381 443045

The term ‘‘method of nasalization’’ has become a titlewhich has been maintained since its origin in the 1950s andhas acquired a reputation.

It was first proved in its contents by the article entitled‘‘The Therapeutic Value of Nasal Vocal Sounds in TreatingFunctional Disorders of the Voice’’ (2).

The title, however, refers only to one focus of the methodwhich is not limited to the principle of nasalization. It ischaracterized by 3 main ideas:

1. Economical use of the voice function.2. Instrumentalization of the voice function (5).3. Concept of therapy according to etiology and patho-

genesis of the disorder.

Economical use means to observe all physiological mo-tions consequently, even those with irreversible organicdamages in order to avoid unfavourable compensatoryresponses, which, in the last analysis, will enhance thedisturbance.

Economical use also means a maximum of effectivenesswith a minimum of energy demand. It has little in commonwith right or wrong, good and bad or a sound ideal.

Instrumentality means to consider the voice as an instru-ment which, similar to a musical instrument, is used withan artistic demand in certain professions. The prerequisitefor it is a wide knowledge of the instrument and a high andtechnical ability of the therapist (6).

The therapy concept means to desist from those measuresof training which without reference to the diagnosis willproceed uniformly. Instead, preference should be given to avariety of training and therapy measures selected individu-ally, which can be drafted individually.

It is based on a terminologically predetermined strongdifferentiation of pedagogical measures together with thecoordination of medicamentous, physical, surgical and psy-chological procedures of therapy in the courses of mono-,simultaneous- and sequence-therapy.

The following brief representation of the method ofnasalization is aimed at:

1. describing its focal points;2. presenting a special terminology; and3. illustrating some examples of the therapy concept.

FOCAL POINTS

The first focal point comprises the common methodicalbasis for training the speaking and singing voice within theframework of a voice therapy and vocalization. This basisis proved by the fact that only one element is used forspeaking and singing, with fluid transitions often existing:

– by fluid limits existing between therapy andvocalization;

– by fluid limits existing between limitation of effective-ness, disturbance and disease;

– by professional demands being frequently made to thespeaking and singing voice in one individual;

– by the fact that a disorder of the speaking function willalso affect the singing function and vice versa;

– by the fact that instrumentaeconomical thinking on amedical basis is important.

The second focal point comprises the principle of nasal-ization. The effect of nasalizing vocal sounds is based onthe inactivation of the velum palatinum during the speak-

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PEVOC-II Supplement 31

ing process, first without any movement of articulation andlater with it, too. The function of the velum palatinum isclosely linked to the whole superior suspension muscles ofthe larynx, which, in turn, will relax during nasalization. Inthis way, the activity of all those forces lifting the larynx isreduced and the coarse tension of the vocal cords is enabledto be increased by the lower suspension muscles of the larynx.

In addition to that, further advantages can be achieved:

1. a bigger resonance space produced by an additional andlonger inserting tube;

2. better modulation of resonance by lower tensions in thepharynx and oral cavity;

3. easier articulatory modulation;4. higher chances of finding the timbre of the singing voice

and in adapting it to an ideal of vocalism;5. lower fatigue effect of the whole voice and speaking

function by economical tensions and motions.

In the course of nasalizing a reflex is briefly used whichbrings the larynx in a favourable condition to the phonatorictension of the vocal cords. After automating this change ofposition the reflex is no longer needed and nasalization canbe abandoned. This happens very quickly and without anyproblems and in each case without endangering the balanceof orality-nasality in the course of articulation.

The third focal point comprises degrees of difficulty invoice practice and training therapeutics. They include 8 stepsfor the speaking voice and 10 for the singing voice. Thesesteps are underpinned by several methodical principles, sothat a continuous development of articulation-free voicegames adapted to the symptom and the individual is ensuredup to the articulation on a pretentious level of voice andspeech. Thus, a wide scope of variation is formed in thetraining concept within these stages of difficulty. It is draftedfor each patient individually.

The fourth focal point comprises the programming ofdynamic stereotypes, emphasizing that all voice therapeutictraining and vocalization made within the framework of theregulating mechanisms of our body have to be concentratedmore on the building, rebuilding and new building of acentral nervous engramme than on the peripheral organ ofsuccess.

The fifth focal point comprises the hearing training. Theaim of the hearing training lies in the auditive sensibilizationof those areas which are built one upon another.

1. Recognizing simple musical features of movement.2. Recognizing formal features of movement in the speech.3. Recognizing pathological and physiological features of

quality in voice and speech.4. Short-term memory for qualities of voice, speech and

movements.5. Long-term memory for qualities of voice and speech.6. Presenting the qualities and movements by means of

graphic representations and terminological denotations.7. Developing a new self-portrait of voice and speech.

In each training treatment the integral part of the hearingtraining consists of using magnetic tape devices and visualrepresentations of voice movements and voice qualities. Forthis purpose, all vocal exercises are represented graphicallyin symbols and denoted with a name. The optical symbol and

the conceptional denotation alleviate the auditive perceptionand make it possible for the therapist to train exactly definedcourses of tension and movements to be met in muscles andto set up exact training tasks for home training.

These vocal exercises cover all those fundamental forms ofmelodious courses of movement found in the natural lan-guage and they can be differentiated into several levels ofdifficulty by including prestages of articulation up to distinctarticulation. By extending them to the marginal register theyeventually enable a fluid transition to be made to exercisesof the singing voice under therapeutical conditions. Forthe purpose of selective hearing training the patients maydispose of magnetic tapes or cassettes respectively. Theycontain:

– general musical elements;– melodious movements of speech;– rhythmic movements of speech;– dynamic movements of speech.

The sixth focal point comprises the age and profession-de-pendent relationship. From the point of training methods therelationships existing between age, physiological voice devel-opment and peak of frequency in voice disorders make itimperative to apply a differentiated adaptation. Conse-quently, training in small children must concentrate onenabling parents and educators to be examples for theirchildren’s imitation, with a variety of nursery rhymes,nursery songs and musical plays forming the nucleus forauditive sensibilization.

The seventh focal point comprises the balance betweenphysical and psychical tension. The aim lies in the followingfields:

1. eliminating tensions of muscles, body and voice functionwithout or with a psychical background;

2. establishing a balanced psychical mood as a basis for aqualitatively optional function of the voice and speech(1);

3. liberating the voice technique from being linked topsychical tensions;

4. controlling emotional tensions in expression andformation.

The method proceeds from the fact that singing andspeaking require high instrumental tensions and fine-myoki-netic changes of tension which, due to economical use andvelocity, must be restricted to small units of function in theregulating circle.

The autogenic training (AT) based on J.H. Schulz (7),extended by Pahn (3), supplemented by music and picturesaccording to Tetrich (8) and gymnastic training (Pahn (4))serves to attain this aim.

REFERENCES

1. Krech H. Die kombiniert-psychologische U8 bungstherapie.Wiss. Z. Universitat Halle, Ges. -Sprachwiss. Reihe 1959; 8:397–430.

2. Pahn J. Der therapeutische Wert nasalierter Vokalklange in derBehandlung funktioneller Stimmerkrankungen. Folia Phoniatr1964; 16: 249–63.

3. Pahn J. Autogenes Training in der Behandlung funktionellerStimmstorungen. Folia Phoniatr 1966; 18: 117–30.

4. Pahn J. Stimmubungen fur Sprechen und Singen. Berlin: Volkund Gesundheit, 1968.

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J. Pahn and E. Pahn32

5. Pahn J, Friemert K. Differentialdiagnostische und terminologis-che Erwagungen bei sogenannten funktionellen Storungen imneuropsychiatrischen und phoniatrischen Fachgebiet. Folia Pho-niatr 1988; 40: 162–4.

6. Pahn J, Dettmann R, Sram F. Zur Verteilung und funktionellenAuswirkungen von Paresen der Stimmlippenbewegungs- und-spannmuskulatur anhand elektromyographischer Untersuchun-gen. Folia Phoniat 1984; 36: 273–83.

7. Schulz JH. Das autogene Training (Konzentrative Selb-stentspannung). Stuttgart: Thieme, 1956.

8. Teirich HR. Musik im Rahmen der nervenarztlichen Praxis. InHR Teirich (Ed.). Musik in der Medizin. Stuttgart: Fischer, 1958.

YHTEENVETO

Laulu- ja puheaanen opetus ja kuntoutusnenasointiharjoituksilla

Nenasointiharjoitusmenetelmalla kuntoutetaan aanihairi-oita. Menettelyt vaihtelevat aanihairion syiden mukaan.Taman vuoksi esitellaan menetelman kayttoa yleisesti kay-tossa olevien diagnostisten kasitteiden yhteydessa. Kaikenkaikkiaan menetelma sisaltaa seitseman ydinajatusta. Ter-apien sisalto on yksilollinen.

Voice loss in performers: a pilot treatment programmeto show the effect on the voice of correcting structuralmisalignmentAngela Caine

The Voice Workshop, Southampton, UK

Log Phon Vocol 1998; 23 (Suppl 1): 32–37

A pilot study has been conducted to determine the importance of an aligned physical structure in vocal performance. A team of a dentist,a cranial chiropractor and a voice teacher assessed and corrected structural misalignments in 9 subjects over a period of 2 years. Thesubjects were all performers or training for professional performance. Posture, upright balance and the voice improved in all the subjects.The improvements included greater control of breathing, increased pitch range, no more fear, greater motivation, and the return of theenjoyment in music making. The results indicate that misalignment of the jaw, the cranium and the skeleton, causes interference in vocalefficiency, rhythm, and confidence.

Angela Caine, The Voice Workshop, 436 Winchester Road, Southampton SO16 7DH, UK. Tel: +44 1703 390555; Fax: +44 1703 390555

INTRODUCTION

Amorino and Taddey (1) conducted a survey in the USA in1994 on the incidence of voice problems in singers who hadtemporomandibular joint dysfunction (TMD). TMD is amisalignment of the jaw in its relation to the cranium whichresults in asymmetrical stresses in the whole head-neck area(see Fig. 1) (6, 10). They found that in the presence of

TMD singers suffered variously from unreliable pitching,running out of breath, performance nerves and a feeling offailure.

Fonder (6) alerted dentists in 1977 to the potentialdamage and stress which they could inflict upon the vascu-lar, skeletal and neural structures throughout the body byaligning teeth for a beautiful smile without considerationfor function or skeletal alignment. The resultant problemsincluded not only physiological symptoms (e.g. neck andshoulder pain, lower back pain, headaches, numbness ortingling in fingers and feet) but also emotional and psycho-logical symptoms (e.g. worrying, nervousness, forgetfulnessand a feeling of failure).

According to Fonder (7) and Guzay (8), the dysfunctionof the mandible in its relationship with the cranium causesspecific muscle spasm in the area of C1 and C2, thusinterfering with the function of the atlanto-occipital joint.The freeing of the neck, and the poise and balance of thewhole body might, therefore, require dental, cranial andchiropractic assistance as well as re-education of habitualpatterns of use to ensure that physical stress patterns donot interfere with efficient function. For example, Zenkerand Zenker (17) in 1960 and Sonninen (14) in 1968 bothsuggested that the extrinsic laryngeal frame assists in regu-Fig. 1. Visible signs of cranial misalignment (8).

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