Soul Retrieval for the Injured Singer: A Psycho-Spiritual Approach to Vocal Rehabilitation

This paper draws on my experience as a singing-voice specialist and my research in depth psychology to explore the human drive to express beauty, emotion, and artistry through the act of singing. Specifically, I focus on what many people in Western culture consider the most demanding, virtuosic style of singing—opera and Western classical singing. I investigate why individuals seem driven to sing opera, and why they experience anguish, a loss of identity, and a sense of failure and depression when they are faced with a vocal injury that inhibits or prohibits their ability to sing professionally. It is my hypothesis that the unconscious conflict and ensuing tension between masculine and feminine principles—the inhibition of the feminine principles of freedom of expression, beauty, and connection, in favor of the masculine principles of control, perfection, and accomplishment—contribute to vocal injury (and, in fact, soul injury) in opera singers. For rehabilitation of the singing voice to be effective and enduring, a holistic approach that addresses unconscious drives affecting the physical as well as psychic balance in the system must be included in the healing journey.

Figure 1: Endoscopic Image of the Larynx

Open position during inhalation

Closed position during voicing

That the larynx bears a striking resemblance to the vagina is not, in my opinion, an irrelevant anatomical coincidence. The larynx, known in common vernacular as the “voice box,” is the cartilaginous structure that houses the vocal folds—the two thin strips of muscle, mucosal tissue, and skin, whose oscillation provides the sound source of human vocalization. The larynx is the vestibule through which thought, emotion, and expressive intent are birthed into being. Completely unknown and unseen by the majority of people who take for granted the reliable use of them, the vocal folds open to allow breath in, and close (suddenly, violently, insistently) to cough out that which they sense would threaten our very existence, or (delicately, precisely, consistently) to provide us with a vehicle to transmit thought and art form from our imagination into the world. The former is central to our biological survival as human beings; the latter is central to our humanity.

What perplexes me about the resemblance between the larynx and the vagina is how often patients of mine, upon seeing an image of their own larynx displayed on a screen, react to it with distaste. "That’s disgusting," they often say, "it looks like a vagina!" Women's proclamations more often reveal, through exaggerated vocal stress and a pained contortion of the face, a certain revulsion and contempt. Men are no less reactive, though they are more likely to shift uncomfortably in the exam chair and mutter something shyly while looking at the floor or snickering like an adolescent overcome by both shame and arousal.

My patients’ overtly expressed aversion to the visualized larynx—specifically because its mere image conjures the essence of feminine sexuality—may well reflect an unconscious abjection of the feminine, one that is pervasive in our current historical context of patriarchal dominance and the unabating diminishment of the maternal. The concept of an underlying maternal principle that originates in our very first bonding experiences with the mother, and is then cut off or rejected by a phallic or paternal principle in the making of an independent self, forms the basis of much psychoanalytic theory, and it is central to the work of Julia Kristeva’s prolific oeuvre on the semiotic and the symbolic order(s) (Smith, 1998). Viewed from within a psycho-linguistic framework, the feminine principle, as it is defined in the acquisition of verbal communication, is what Kristeva describes as thesemiotic, pre-verbal sign [that] announces prosody, poetry’s departure from prose, musicality, and the unspeakable forces, energy and drives, which poets and artists strive to express in their attacks against and modifications of traditional forms; it announces the infancy of the child and of the child’s relationship with the mother prior to language acquisition and symbolic separation. This is a phase that psychoanalysis refers to as the pre-oedipal or as primary narcissism, a state of being which precedes the evolution of oedipal identity in the symbolic form. (Smith, 1998, pp. 15-16)

According to Kristeva (Smith, 1998), our emergence from the body of the mother and our subsequent entrance into the symbolic order leads us to abject or discard the mother, thus cutting off from that which presumably no longer serves us (a diffuse, connected oneness without boundaries), in favor of that which presumably will: the patriarchal order of the father (rule-based law and order). The semiotic, then, is, in essence, the voice, and also, the feminine, unconsciously rejected (as when a patient responds to an image of the larynx in disgust) and also, unconsciously longed for or desired. “The voice as object is thus constructed both as lost object and as first object of jouissance. It is thus not surprising that a quest for the object is set in motion, a search for lost phonic materiality, now dissolved behind signification” (Poizat, 1992, p. 103).

Of course, the voice, the feminine, is not, cannot be lost, although it can be and often is suppressed, ignored, or held in contempt—pushed to the depths of the unconscious in favor of “rational” thought and concrete action. Yet the voice, the feminine, finds its expression, often by subverting the masculine, symbolic order, Kristeva argues, through art. Although the symbolic order would attempt to relegate the voice to nothing more than a carrier for the word, the semiotic rises up, takes its place, demands to be heard, perhaps nowhere as clamorously as in the singing of opera.

Singing represents a different stage: it brings the voice energetically to the forefront, on purpose, at the expense of meaning. Indeed, singing is bad communication; it prevents a clear understanding of the text….The fact that singing blurs the word and makes it difficult to understand—in polyphony to the point of incomprehensibility—has served as the basis for a philosophical distrust for this flourishing of the voice at the expense of the text: for instance, for the constant efforts to regulate sacred music, all of which tried to secure an anchorage in the word, and banish fascination with the voice. Singing takes the distraction of the voice seriously, and turns the tables on the signifier; it reverses the hierarchy—let the voice take the upper hand, let the voice be the bearer of what cannot be expressed by words…The birth of the opera was accompanied by the dilemma of prima la musica, e poi, le parole [first the music, and then, the words], or the other way round; the dramatic tension between the word and the voice was put into its cradle, and their impossible and problematic relationship presented its driving force. (Dolar, 2006, p. 30)

Singing, then, as one of the most exquisite examples of that which subverts the symbolic order, contains within it an unconscious drive to return to a sense of oneness that was experienced prior to our first inkling that we are separate from the mother from whose body we have emerged. It represents a desire to reclaim “paradise lost,” within the framework of an inner conflict or tension that comes from knowing, consciously or unconsciously, that what is lost is, ultimately, unrecoverable. Although singers may feel inexplicably driven to attempt to recover the boundless, borderless experience of pre-verbal connection through song, they are caught in a conflict between freedom of expression and an obligation to navigate and negotiate their expression through the symbolic function.

By symbolic function we mean a system of signs (first, rhythmic and intonational difference, then signifier/signified) which are organized into logico-syntactic structures whose aim is to accredit social communication as exchange purified of pleasure. From the beginning, then, we are dealing with a training process, an inhibition, which already begins with the first echolalias, but fully asserts itself with language-learning. If the pre-Oedipal phase of this inhibition is still full of pleasure and not yet detached from the mother/child continuum, it already entails certain prohibitions: notably the training of the glottal and anal sphincters. And it is on the foundation of these prohibitions that the superego will be built. (Kristeva, 1986, p. 150-151)

Here, in her description of the imposition of control over the glottis (the space between the vocal folds) through the sphincteric closure of the vocal folds that that must be maintained during phonation, Kristeva delineates the process of gaining complete, unrelenting control over the vocal mechanism (discarding the pure pleasure of uninhibited sound in favor of shaping that sound into something recognizable within the guidelines of the symbolic order) that is so familiar to trained opera singers. According to Kristeva, this process involves more than just physical control; it includes a superegoic internalization of moralistic dictums—concepts of good and bad; the imposition of guilt and shame. In an operatic context, the control of the voice through these dictums that are commensurate with the function of the superego infiltrates nearly every aspect of operatic consciousness. From weekly lessons and master classes in which the voice is constantly criticized and corrected in order to force it to conform to a centuries-old standard of singing, to competitive auditions that are commonly referred to as “cattle-calls,” in which singers are judged on their performance and then praised or rejected within minutes of presenting themselves for evaluation by “experts” who wield a kind of omnipotent authority, opera represents a somewhat harsh microcosm of our more general patriarchal narrative—it has completely commodified the voice, and, ultimately, the feminine, for audience consumption.

When singers, particularly those who are more inclined toward the feminine principles of sensitivity or receptivity and less inclined toward the more masculine principles of competition and a drive to achieve, attempt to succeed within a rigid, perfectionistic, competitive operatic culture, an unconscious conflict is set up in which singers simultaneously desire to experience the almost mystical, ecstatic freedom of expressing beauty through an agile and unencumbered corporeal vocal instrument, while they also feel restricted by rules, judgments, and expectations.

The resulting pressure inflicted on the vocal folds through hyper-adduction (excessive “squeezing” or resistance at the level of the larynx), combined with too much forced air pressure through the vocal folds, causes the singer to drive the voice beyond its own unique physiologic limits, creating damage to the vocal fold tissue. Under this pressure, the vocal folds begin to either “crack” or swell, resulting in interruptions to the smooth transitions between notes in the pitch range (register breaks), or benign lesions of the vocal folds (e.g., nodules, polyps, and cysts), causing a disruption in sound quality. This chronic strain on the muscles of the vocal apparatus and/or damage to the soft tissue of the vocal folds results in pain, fatigue, reduced vocal endurance, and chronic roughness, breathiness, or strain. For an ordinary speaker, these symptoms can have a significant impact on one’s ability to communicate, and subsequently, one’s quality of life. For a singer, particularly an opera singer, these symptoms can have a debilitating effect, not only on one’s career, but on a singer’s very soul.

For all its exquisite beauty of sound and delightfulness of costuming and elaborate staging, and in spite of the tremendous personal fulfillment that can be achieved through training the voice to an Olympian level of skill and mastery, opera is a most unforgiving art form. “In the worst of cases, a missed note will reduce [the singer] to outcast status, to the status of refuse, and arouse the aggression of the frustrated listener” (Poizat, 1992, p. 66). Once damage has occurred to the vocal apparatus, the operatic voice loses its purity of tone and predictability of performance. A singer may lose notes in his or her upper register, the voice may become inconsistent, it may lack strength, agility, or clarity. When this happens, the singer himself or herself is rejected, often “blackballed” from ever being hired again to perform. While athletes who injure will typically be removed from play, rehabilitated, and returned to the field, when singers injure, there is a deep and pervasive sense that they have done something wrong. A singer who has suffered a vocal injury suffers beneath a shroud of secrecy and shame. As one tenor at the San Francisco Opera expressed to me,

“Singers injure all the time, but nobody would ever admit it. They just hobble off stage after a performance one night with ‘back pain,’ and they return six or eight weeks later, ready to perform again. Everybody suspects they had surgery on their vocal cords to remove a polyp, but you’d think, by the way they dodge the subject when you ask about their chiropractor or physical therapy, that they’d gone off to have some back-alley abortion.”

Unfortunately, simply removing a benign lesion surgically is rarely an ideal, nor a permanent solution. Vocal fold lesions removed surgically with no peri-operative vocal retraining or rehabilitation tend to recur, as the habituated behavioral patterns that originally contributed to their formation have not changed. Vocal rehabilitation is a lengthier process than surgery, often requiring many months of intensive voice therapy, and, because singers are terrified by the possibility of “being found out” or of “losing their place” or momentum in their careers, many singers are unwilling to seek appropriate treatment with a qualified voice specialist, preferring to “push through,” hoping that nobody will notice as their voices continue to falter, sometimes to a point of incurring permanent damage.

Once the voice is damaged, whether permanently or temporarily, a singer often feels both that he or she has been betrayed by the body, and, also that he or she has done something wrong to harm the body. Guilt, fear, and shame arise, often escalating to despair. The larynx itself, originally unconsciously ignored, abjected, or objectified, now becomes the object of sadness, hatred, or obsession. A kind of internalized warfare occurs, in which the larynx is treated as an uninvited interloper wreaking havoc on a singer’s dreams, desires, and, often, livelihood. First, it was the object of pursuit, and, as long as it was serving the singer’s needs and performing on command, there wasn’t much reason to pay attention to it. Once the instrument has failed in its subservient role as a kind of object to be controlled and manipulated, it becomes the hated, rejected, though still desired, object. The superego takes on its extreme role as punisher and judge, and the singer is at risk for entering into an abusive relationship with the shunned, but also longed-for, voice.

The injured singer feels that he or she has failed, will never live up to opera’s expectations of perfection, and, now, must forever carry the secret shame of his or her inadequacy. The deep sadness, sense of loss, and, often, loss of identity that follows emerges as a type of soul-loss—the sense that a core and significant essence of the self has become damaged, disconnected, or has gone into hiding. The experience of vocal injury is frequently described by injured opera singers as the sense that something within the self that once felt whole is now broken and can never be repaired. Even if they rehabilitate, heal the vocal fold tissue, eliminate their symptoms, and, through re-training, discover an even stronger, fuller, more resonant voice, they still carry the fear that, at some point in the future, “the other shoe will drop,” and it is just a matter of time before the same vocal injury will recur, or, they will be “found out” as a “fraud” for having sustained a vocal injury to begin with.

Injured opera singers often state that, at the time of vocal injury, they had an intuitive sense that they were pushing their vocal instruments beyond what they were physically comfortable doing. Yet, they continued to “push” the voice beyond its capacity to in order to appease another person’s demands or an operatic ideal. The therapeutic process, then, must involve not only a physical retraining of vocal technique to decrease the amount of pressure that is being driven into the vocal folds, but, ultimately, it must include a more holistic approach designed to uncover the underlying psycho-spiritual drives that have caused a singer to push the voice beyond its physiologic limits.

To approach vocal rehabilitation as a process that includes soul retrieval, it is necessary to re-balance the whole system, physically, psychologically, and spiritually. The singer who has turned on his or her own body must learn to develop a less adversarial relationship with the self. This entails cultivating a more embodied sense of grounded awareness in the physical body, rather than seeing the voice as a disembodied object that is there to do the ego’s bidding, whether for fame or achievement, or for the experience of pleasure or ecstasy, at the expense of sensitized responsiveness to the body’s cues that it is being abused or overused in some way. This includes not only feeling into bodily sensations during the act of singing, but also being conscious of foods and substances that are being ingested that either nourish or harm and deplete the physical body. Ultimately, this means entering into a relationship with the body as a conscious entity that is in constant communication with our selves, and we must learn to listen to its subtle cues.

Psychologically speaking, a singer must become aware of the “disembodied voices” of the superego, and, also, the abjected feminine. A singer must seek to achieve balance and unity between the masculine and the feminine principles, with neither dominating or subverting the other. When the internal dialogue of the injured singer says, “the voice is not doing what I want it to do, or, more precisely, what my audience or my director or my legal contract say it’s supposed to do to fulfill this role. The voice must do as I say,” this is not a dialogue, but a rather harsh, dictatorial monologue. It might behoove a singer in this circumstance to actually make this conversation a dialogue, allowing the voice itself to have a voice in the conversation.

Spiritually speaking, the voice must express the soul without trampling upon that very same soul—whether through a disregard for the body, for The Mother, or for the extraordinary experience that was originally sought through the “…articulation between vocal jouissance and worship, between vocal jouissance and the relation of the human to the divine, between lyric and mystical ecstasy” (Poizat, 1992, p. 47). Because this, ultimately, is what is sought through operatic expression—the achievement of an embodied yet ecstatic state for performer and audience alike.

The voice is endowed with profundity…. it promises an ascent to divinity, an elevation above the empirical, the mediated, the limited, worldly human concerns. This illusion of transcendence accompanied the long history of the voice as the agent of the sacred, and the highly acclaimed role of music was based on its ambiguous link with both nature and divinity. (Dolar, 2006, p. 31)

Opera, in its most profound moments, offers a unity of opposites: an elegant marriage between pure sound and word, between inhale and exhale, opening and closing, interior and exterior, masculine and feminine, the voice and silence. It is in the unification of these opposites that an injured opera singer will reclaim a more integrated wholeness, healing body, psyche, and soul.

References

Dolar, M. (2006). A voice and nothing more. Cambridge: The MIT Press.

Kristeva, J. (1986). About Chinese women. In T. Moi (Ed.). & S. Hand (Trans.).

The Kristeva reader (pp. 139-159). New York: Columbia University Press.

Poizat, M. (1992). The angel’s cry: Beyond the pleasure principle in opera. (A.

Denner, Trans.). Ithaca: Cornell University Press. (Original work published 1986)

Smith, A.-M. (1998). Julia Kristeva: Speaking the unspeakable. London: Pluto Press.