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Krylyn Peters Jun 24, 2010

The Voice and Mental Illness

As an undergraduate, I was fascinated with my communications classes. So much so that I had almost enough credits for a double major along with my psychology degree. Perhaps it was because I grew up confused in a household where what was said was rarely what was meant, but I was amazed to find out how much of our communication is done without words. And I continue to be amazed at the power of nonverbal communication to this day.

Paralanguage is everything but the words that we convey by speaking. It’s the way we say things and the quality of our vocal tone. It’s the part of language that communicates our inner states, including moods and feelings. As counselors, we are experts in paralanguage.

There are three key aspects of paralanguage:

  1. Meter or Rate (fast to slow): The speed of delivery of words or sounds.

  2. Pitch (high to low): The lowness or highness of words or sounds.

  3. Volume (loud to soft): The loudness or softness of words or sounds.

Your client’s voice says a lot about how they are doing. Think about someone you have worked with who is experiencing symptoms of depression. How fast or slow do they speak? How high or low? And how loud or soft? Many of the clients I have worked with who have current symptoms of depression are slow, low, soft talkers. But catch them on a good day and their speech may sound very different.

How do you think clients with the following diagnostic symptoms might sound: ADHD, ODD, OCD, GAD, Panic D/O, Psychosis (negative symptoms), Psychosis (positive symptoms)? While there will likely be some similarities, it’s important to note that no two clients with the same diagnosis are going to sound exactly the same. Any comparison about how fast, slow, high, low, loud, or soft people speak should be made against their own speech during different levels of reported or observed symptoms.

While you already intuitively gauge how your client is doing when you first hear them speak, see if you notice anything new by really listening for meter, pitch, and volume. You might be surprised to hear something you hadn’t been listening for and your insights might really help your client. For example, you might say, “I notice you’re speaking really softly today and that you say you’re feeling depressed. Thinking back, I’ve noticed you tend to speak softly when you say you’re feeling depressed. What do you think?”

Another idea is to have your client use the OPPOSITE side of the scale. For example, if your client is experiencing depression and exhibiting slow meter, ask them to talk fast for a few seconds. Or, if your client is experiencing symptoms of anxiety and exhibiting high pitch, ask them to speak in a low voice but continue the same volume and meter. Ask your client if they notice a difference in their mood, thoughts, or feelings.

Krylyn Peters is a counselor and singer/songwriter (aka songwriting therapist™) who uses the power of music and sound for healing.
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