There is no conjecture that Whitney Houston’s voice was simply “The Voice” of the 80’s and 90’s. Her beautiful mezzo-soprano could resonate and send shivers down your spine. At her peak, she was referred to as simply “The Voice” with her perfect combination of passion, splendour and brilliance. However, whatever happened to that glorious voice that we all fell in love with? In later life (prior to her unfortunate death) Whitney Houston’s voice started to decline – her pitch changed, her voice become low and raspy, her vocal range weakened, and her rich timbre became almost obsolete.
Whitney Elizabeth Houston was born in Newark, New Jersey on the 9th of August 1963 into a family of singers. Her mother was the legendary gospel singer Cissy Houston, and her cousin was the famous Dionne Warwick. Whitney Houston gained success in the 80’s when Clive Davis signed her with Arista records. From then, she walked into a world of achievement not only as a singer, but also as a model, actress and producer. In 2009, the Guinness Book of Records cited Whitney Houston as the most awarded female artist of all time.
It is no secret that Whitney Houston’s voice started to decline after her famous anthem “I will always love you” written by Dolly Parton. Speculation grew as to why her voice had changed, however these rumours were only confirmed by Whitney Houston in an interview with Oprah Winfrey in 2009. Whitney had been a substance abuser, smoking cocaine laced with marijuana. Her voice also started to deteriorate around 1993-1994 when she supposedly developed vocal fold nodules but was unable to rest to prevent further damage to her larynx (voice box) due to work commitments.
Vocal fold nodules are small bumps (like a small callus) which develop on the vocal folds. Over time, they develop from a slight reddening, to a swelling and then to definable nodules. They occur on both folds and are symmetrical. Nodules are a problem because they may create a gap between the vocal folds, allowing air escape and preventing normal vibration. Vocal nodules are mainly caused by phonotraumatic behaviours, meaning behaviours that cause trauma to the larynx (voice box). These phonotruamatic behaviours often occur as a result of vocal misuse and abuse; for example, through vocal belting, yelling, shouting, excessive drinking and/or smoking. Furthermore, these phonotraumatic behaviours can alter how the voice sounds both when speaking and singing.
Unfortunately from years of smoking and vocal overuse and abuse, Whitney Houston was unable to regain that golden, silky, rich timbre of her beautiful voice that we all fell in love with. She still, however, will always be remembered as one of the greatest female vocal artists of all time, and personally my favourite singer of all time.
Below is an outline on how voice is produced, the factors that contribute to voice disorders and ways to avoid developing voice disorders for singers.
How is voice produced?
Voice is any sound that is produced by our vocal folds including yelling, shouting, screaming, babbling, talking and singing. The voice box (larynx) is where the vocal folds are situated. The larynx is also referred to as the voice-generating system. Vocal folds are twin mucous membrane infoldings that are stretched across the larynx. Voice (or vocalisation) is the sound produced when air travels from the lungs through the vocal folds in the larynx. The human voice conveys information about the speaker through features such as pitch, loudness, resonance, quality and flexibility. Good breath support is essential for adequate voice production for without this, we cannot generate or produce sufficient voice. When we breathe in on inhalation our vocal folds are abducted (apart), however as we exhale, our vocal folds come to midline (adduct) to generate sounds. As we inhale, the air generated from the lungs creates an air pressure beneath the vocal folds (subglottic pressure). When the air pressure below the vocal folds exceeds the air above the vocal folds, a burst of air will escape through the folds causing them to vibrate. As the air rapidly flows through the larynx, it creates a decreased pressure (a phenomenon called the Venturi effect) and the vocal folds are brought together. The process of rapid opening and closing produces vocal fold vibration. Each time the vocal folds open they produce a jet of air which creates a rapid change in air pressure that produces the sounds we use to communicate.
What are the symptoms of voice disorders?
The symptoms of voice disorders vary depending on the type of voice difficulty. Generally, the onset of symptoms is gradual, with short episodes of symptoms experienced. However, this can become a problem if eventually these symptoms occur more frequently (i.e., symptoms experienced all the time).
What to look out for:
- Rough, hoarse or raspy voice
- Breathy or husky voice
- Reduced vocal volume
- Changes to voice pitch
- Pain or discomfort in the throat
- A tight ‘choking’ sensation when using voice
- A feeling of a ‘lump’ in the throat
- Increase fatigue and effort associated with increased voice use
- Complete loss of voice
What causes Voice Disorders?
Voice disorders can be caused by various factors including traumatic events, physical ailments, prolonged intubation and/or diseases. Voice disorders are generally not considered life threatening. Behaviours that can lead to voice problems (‘Phonotraumatic’) include:
– Excessive use of voice which may be exacerbated when underlying poor health (i.e., infections/virus)
– Constantly using a voice that is not within usual vocal range or ‘putting on a character voice’ (i.e., Batman vs. Bruce Wayne)
– Any behaviour that causes strain to the vocal mechanism (phonotraumatic)
– This may include yelling, screaming, shouting or singing loudly
– Changes naturally occur to the voice as we age
– Parkinson’s disease, motor neuron disease
– Smoking, passive smoking, drinking (excessive alcohol and/or caffeine), drug use, surgical
– Increased muscle tension, posture
– Stress, anxiety, depression
– Often head and neck related illnesses such as laryngitis, tonsillitis, head cold, pneumonia, H&N cancer
– Lead to dry mouth and changes to mood/emotion/stress
Types of Voice Disorders
Anatomical changes to structures of the voice box or the nerves that control voice production
- Vocal Nodules
- Vocal Polyps
- Paralysis of vocal folds Neurological disorders e.g., Parkinson’s disease
Voice disorder that occur due to poor muscle functioning
- Muscle Tension Dysphonia
- Vocal fold bowing
- Excessive movement of the vocal folds (hyperADuction or hyperABduction)
What can singers do to maintain good vocal quality?
If you use your voice on a daily basis as a means of income or as part of your occupation, you are a professional voice user. As a professional voice user, it is important that you take good care of your voice by ensuring that adequate vocal hygiene and care strategies are incorporated and integrated into your daily lifestyle.
Vocal care and hygiene is essential to sustain and maintain good quality of voice whether it is when singing or speaking. Vocal care/hygiene strategies for singers include:
- Vocal warm-ups and cool-downs
- Having a water bottle with you when singing. You should be having water pre and post speaking/singing and during short breaks where possible. Even if you don’t ‘feel’ thirsty – ensure you maintain adequate hydration
- Quitting smoking
- Reducing the amount of drying agents (alcohol/caffeine) consumed. Alcohol and caffeine can be drying to the entire body. Drinking them makes the vocal folds drier. Cutting back on caffeine and alcohol can help your body stay hydrated. Substitute water, herbal teas, lemon juice for caffeinated drinks
- Avoiding dusty/smoky environments
- Avoiding yelling, shouting, screaming or vocal belting inappropriately
- Avoiding excessive throat clearing/unnecessary coughing
- Resting your voice (avoid talking/singing on your days off)
What does voice therapy for singers involve?
Your voice is the sound that emanates from your voice box (i.e., larynx). Voice therapy can assist disorders that result from functional or anatomical problems that manifest at the level of the larynx. Medical problems such as vocal fold polyps, paralysed vocal folds, vocal fold nodules and other related abnormalities can be treated with voice therapy. For instance, a person with polyps or cysts on their vocal folds may have a raspy or breathy sounding voice when singing or speaking.
There can also be psychological components that cause voice disorders for speakers/singers. In order to receive proper treatment, it is imperative to schedule a consultation with a specialist in Sydney who can perform a series of diagnostic assessments. These assessments will provide diagnostic information on the specific voice difficulty that an individual may have so that a tailored treatment plan can be followed.
It is also important for singers to seek the advice of singing/voice teachers who are able to provide specific techniques on improving singing ability.
For more information about maintaining good vocal care/quality or if you have noticed any voice changes, please contact our Speech Pathology team at ENT Clinic Randwick.
Contact us for results focused speech therapy
This article was written by our speech pathologist Eugene Pillay who is a Speech Pathology Australia member.
If you have questions about Voice Disorders or for results focused speech therapy, contact your local doctor who will arrange for you to see a speech pathologist in Sydney.
Boone, D.R., McFarlane, S.C., & Von Berg, S.L. (2005). The voice and voice therapy (7th ed.). USA: Pearson Education Inc. Colton, R.H., & Casper, J.K. (1996). Understanding voice problems: A physiological perspective for diagnosis and treatment (2nd ed.). USA: Lippincott Williams & Wilkins.
Duffy, J. (2005). Motor Speech Disorders: Substrates, Differential Diagnosis and Management. (2nd ed.). Missouri: Elsevier Mosby.
Ettema, S.L., Tolejano, C.J., Thielke, R.J., Toohill, R.J. & Merati, A.L. (2006). Perceptual voice analysis of patients with subglottic stenosis. Otolaryngology–Head and Neck Surgery, 135, 730-735.
Hirano, M. (1981) Psycho-acoustic evaluation of voice. In: M. Hirano (Ed.), Clinical Examination of Voice (pp. 81-84). New York, NY: Springer-Verlag.
McKinney, J. (1994). The Diagnosis and Correction of Vocal Faults. Nashville, TN: Genovex Music Group.
Pennebaker, R.B., Slatcher, R.B., Ramirez-Esparza, N., Vazire, S., & Mehl, M.R. (2007). Are Women Really more talkative than men? Science Magazine (Department of Pyschology, University of Arizona).
Russello, C. (2010) Teaching Respeaking to Conference Interpreters. Retrieved from http://www.intersteno.it
Schindler, A., Bottero, A., Capaccio, P., Ginocchio, D., Adorni, F., & Ottaviani, F. (2008). Vocal improvement after voice therapy in unilateral vocal fold paralysis. Journal of Voice, 22(1), 113-118.
Van Houtte, E., Claeys, S., Wuyts, F., & Van Lierde, K. (2011). The Impact of Voice Disorders Among Teachers: VocalComplaints, Treatment-Seeking Behavior, Knowledge of
Vocal Care, and Voice-Related Absenteeism. Journal of Voice, 25 (5), 570-575.
WHO (World Health Organization) 2001. International classification of functioning, disability and health. Geneva: WHO.