Report: Sudden loss of voice / aphonia
Ms. M sang a lullaby to her 4-year-old son in November 2018 – her voice was fully functional. The next song she sang normally for the first couple of minutes, and then her voice suddenly disappeared. It felt a little hoarse for a moment, then she could not talk at all any more. She lay down to sleep and woke up the next morning without any voice problems.
Since she has basic knowledge of the 5BN herself, the causal context of this symptom was already clear to her without our subsequent more detailed analysis: When her son was a baby, she always sung him her favorite lullaby. At some point, at the age of two, he suddenly interrupted her during that song and “forbade” her to continue singing it. This repeated over the next few days, until she ceased singing her favorite song altogether and instead continued with other songs.
Due to the arrival of their second child, her husband assumed the role of putting their older son to bed at night. A year and a half passed in this manner until she resumed tucking her eldest, now 4 years old, back into his bed. He asked her for the first time in years: “Will you sing something for me?” Habit brought her favorite lullaby to her lips and she immediately had the uneasy feeling that he would interrupt her again. This did not happen, he relaxed and she could sing the song to its end. This was the moment of conflict resolution and the trigger for the subsequent loss of voice:
The vocal folds are a complex apparatus of arytenoid cartilages, mucous membranes, vocal folds, muscles, etc. Depending on the tissue involved, this leads to different types of voice changes or loss.
In this case, the loss of voice occurred very suddenly and completely without pain, so it can not be due to organic inflammatory processes but must be a purely neuronal process:
The neuronal innervation of the muscles of the vocal cord have as conflict content: “not to be allowed to speak something”, that one is forbidden to say something. In long, intense conflict-active phases, this will eventually lead to paralysis of these muscles; In shorter, lower intensities, as in this case, there will be no noticeable symptoms. After conflict resolution, the local swelling in the control relay in the brain leads to a sudden function reduction. In her case, the muscles could not be neuronally addressed and controlled, but once the swelling in her brain subsided, the function returned to normal.