General Information

   What is psychogenic dysphonia?  Psychogenic dysphonia is a voice disorder that has no obvious organic etiology and is present in conjunction with emotional stress (Butcher, P., Elias, A., and Raven, R., 1993).  This seems apparent in everyday life, such as when a person is sad or crying, it is heard by breaks and changes in the voice.  So it makes sense that a person experiencing emotional stress for long periods of time could result in a voice disorder.  A psychogenic dysphonia can sound like anything form a strangled, strained voice with high tension, to a aphonic voice that is barely audible.

   Who gets psychogenic dysphonia?  Although psychogenic dysphonia is seen in more woman than man, anyone is able to get this disorder, children as well as adults.  Everyone suffers from stress, anxiety, and depression.  However, there is no clear answer to why only certain people respond from these elements with a development of an abnormal voice.  The only suggestion to this is that certain people are predisposed by personality or physiology to hyperreact through a particular neuromuscular organ system (Aronson, 1980).

    What makes a disorder psychogenic?  Fawcus (1992) noted that there are three conditions that make a disorder psychogenic: "psychological disequilibrium, voice is constantly affected, and no physical or structural etiology present".  Clients often report a traumatic emotional event closely associated with the awareness of the onset of symptoms.

    Types of psychogenically based voice disorders:  There is no single way to characterize the patterns of persons whose voice problems are psychogenically based, however, Colton and Casper (1996) "have encountered a wide diversity of patterns, including (a) total aphonia in which even the voiceless consonants were inaudible and the vocal folds were maintained in an abducted posture; (b) dysphonia in which the laryngeal mechanism was held in a tension equal to that of very forceful effort closure, with episodic bursts of explosive vocalization alternating with extreme hoarseness: (c) dysphonia in which the ventricular folds appeared to adduct; and (d) dysphonia so variable that it encompassed normal voicing, aphonia, hoarseness, and very strained phonation, all within two or three sentences."

   Conversion Voice Disorders:  A conversion voice disorder is a subcategory under psychogenic disorders.  However, they relate rather closely.  According to Aronson (1980), "a conversion voice disorder
    (1) exists despite normal structure and function of the vocal folds,
    (2) is created by anxiety, stress, depression, or interpersonal conflict,
    (3) has symbolic significance for that conflict, and
    (4) enables the patient to avoid facing the interpersonal conflict directly and extricates the person from the uncomfortable situation."  A conversion disorder can manifest itself in the form of muteness, aphonia, and dysphonias such as breathiness, hoarseness, falsetto pitch, and continuous falsetto.

Psychological vs.
Neurological Etiology