Voice, and the Problems of Self Protection: PART 1

We explore, in Part 1 of this fascinating conversation, the hidden voice difficulties when scopes are clear but a voice isn't working, and how guarding, fear, and judgement can lock a healthy system. Dr Jenevora Williams shares the 'guarded larynx concept', playful strategies to reset tension, and why deep listening often reveals the real story.

• Muscle Tension Dysphonia as a limited descriptor
• whole-person view of voice beyond folds and breath
• ruling out neurological causes and red flags
• guarding as a protective pattern applied to voice
• triggers from criticism, stress and life events
• compensations hardening into habits over time
• playful sound-making to reduce judgement
• variability for motor learning and expressive range
• fear-avoidance model and building safety
• boundaries and scope for non-clinical coaches
• teasers for part two on hypersensitivity and psychogenic loss

So drop us a line, be in touch, and until we meet again, I hope that your voice finds the space it needs to be really heard

Find me on Instagram

https://www.instagram.com/nkvoiceworks/

LinkedIn 

https://je.linkedin.com/in/nkvoiceworks

Transcript

Setting The Stage: Hidden Voice Issues

Speaker 0:00

Welcome to VoiceCast. This next two episodes is really one conversation with my friend and colleague, Dr. Jenevora Williams, who is a voice rehabilitation specialist coach. That's a non-clinical pathway. It's not the same as a speech and language therapist, but it's, I suppose, a singing teacher or voice coach with superpowers in the vocal health department, somebody who really regularly spends time working alongside voice surgeons and speech and language therapists in voice clinics. So it was a really rich conversation, and I ended up splitting it into two episodes because I felt there was just so much rich mining to be had in there, and I didn't want to cut anything out. The overall conversation in both episodes is around those moments when the voice doesn't quite work how it's meant to, but there is nothing to see on the vocal folds. In other words, there is no organic pathology, nothing biological to see. And yet that voice user knows that they can't use their voice in the way they want to. Now, this can range along a spectrum from a person not being able to reach their high notes or losing a bit of stamina if they're a singer, just getting tired towards the end of the week if they're a teacher, for example, right the way through to the other end of the spectrum, where you have functional neurological voice disorders and psychogenic voice loss, where a person might have completely lost their ability to speak, and yet there's no clinical, obvious reason for that. And we explore in this conversation ways that we might talk about these things, compassionate ways that we might help people who are struggling with their voice. What might work, what might not work, where might these problems originate? And it's something around how much the voice is a part of a whole human being that cannot be isolated into just breath going through vocal folds. There is just so much at play, and it's around the nervous system, it's around the breath, it's around traumatic events in some people's cases. It's it's so many things. So I hope you'll find this a really interesting listen, and I hope that you'll enjoy both episodes. This is VoiceCast with Nikki Kennedy, exploring voice in every sense, the sound you make, the story you tell, and the presence you bring. I'm Nikki Kennedy, your host, a classical singer, vocal health and rehabilitation specialist, and an executive coach. And my work is about helping people transform, find new directions, get unstuck, and express themselves in ways that feel authentic and true. Together we'll look at how your voice and your presence can shape change in work, in life, and in yourself. Ginevra is a thought leader in vocal health and is a natural teacher who, with her colleague Stephen King, has set up vocal health education, which has created a coherent training and education pathway to help singing teachers and other vocal coaches to become better informed about vocal health and better able to operate as a support system for singers and voice users who are struggling with their voices, often in collaboration with clinical teams and with other practitioners. Much of Ginevra's work is with singers and professional voice users who develop persistent vocal difficulties, often without any clear structural diagnosis. And that's part of the conversation today. It's when when we look well, what I mean by that is we can look at somebody's vocal cords and there can be apparently nothing wrong. But that voice user knows that they are losing stamina, losing range. They're just not, their voice doesn't work how they think it should or how it has done in the past. So that's frequently described under an umbrella term, which is muscle tension dysphonia. So we'll be talking a little bit about that and many other things. I think we're in for a great conversation today as we delve into some of the complexities of helping clients with voice issues. After all, our voice and identities as humans are very, very closely tied together. And I know from my own practice that many voice problems, or even maybe most voice problems, are caused not by just one training or performance event, but by a cocktail of different influences from biological stresses to psychological and social factors. So a really warm welcome, Ginevra. How are you?

Speaker 1 5:22

I'm very well. I'm so looking forward to talking to you, Nikki, about all of this stuff.

Speaker 5:29

It's it's wonderful stuff. And I I'm one of the things I'm really looking forward to getting to, I know that you and Stephen King have recently published a paper that we're going to spend a bit of time talking about. But first, let's talk about this catch all diagnosis of muscle tension dysphonia, this kind of we can't see anything, but we know that there is something that isn't working. What might be at play when a singer has one of these diagnoses?

Speaker 1 5:57

It's a very interesting term, and like a lot of these descriptions, it's been modified as time goes on, because descriptions can get stuck and then they become a label that becomes sometimes unhelpful. And then a whole team of experts sit down and look at everything and come up with a different description that might be more appropriate, and then that would last for a few more years, and then that gets stuck. And this is shows us how language shifts and meaning shifts. And so it is just a description, it's not really a diagnosis, because there's nothing pathological, there's nothing to see, there's nothing to measure. All we have is a description from the individual to say that their voice isn't working how they would like it to, or how they had were familiar with. And it may not be evident to the specialist that there is a problem.

Speaker 7:04

Just for clarity's sake, if we talk about a a diagnosis where there is something organic to see, that might be a polyp or a cyst or some nodules, or it might there are a number of different things that can have an impact on how somebody's vocal folds or vocal cords come together. So we're saying that actually in this case, it's just simply that there is no evidence of why the voice isn't working, but we just have that client's report that it isn't.

Speaker 1 7:35

I mean, there are other things to look for, um, and it is important to rule these out. And those are neurological issues, and sometimes a voice problem may be an indicator of some kind of developmental thing like Parkinson's or um motor neuron disease, or these these sort of diagnoses which can be measured if you do the right kind of scan.

Beyond Labels: MTD And Its Limits

Speaker 8:03

So it's very important that people have that initial contact with a laryngologist or an ENT to rule things out. But say, for example, somebody has had this description applied, muscle tension dysphonia, and they may have been offered some speech and language therapy, they may be a singer, they may be wanting to get back, but they still may feel that things aren't quite right. What then? How can we work with these individuals?

Speaker 1 8:30

The first thing I do is sit down and have a chat. And I ask them to tell me what's been going on. You know, tell me why you're here, tell me, tell me what's been happening. And then depending on how they respond, I'll then ask more questions, go back further in time, maybe draw together connections from other things they tell me. There isn't really a formula. People often ask me for my intake form and what questions I ask. And I I just don't have one because it's it's iterative. It all depends on what they say, and it depends on how they look, and it depends on what they've done and how old they are, and what their experience is and what they want. You know, that's a very early, early question is what would you like to be able to do that you I'm struggling with at the moment?

Speaker 9:28

Hmm. I think that's really interesting because I also don't well I ha I I think I did write an intake form, and I don't think I've ever used it. Because really there is just so much about the flow of observation and conversation that that happens in that in that first kind of meeting, isn't there? Uh there's a lot that can be observed. And and of course we know that with the voice, change can be quite slow. There may be many, many things playing into why somebody's voice isn't working. It could be very simple things like medication and hormonal shift, uh, but it could be something much more complicated. What kinds of things do you often come across, would you say?

Speaker 1 10:14

I would say that it's almost always a combination. Because any one single factor, like hormone shift or a change of medication, can normally be noticed and dealt with quite and it's quite straightforward to notice and deal with it. But when it's uh a complicated combination of different things that may have been building over time, then it takes a lot more unpicking because it's not just circumstantial things, it's not just you know what antidepressants you're taking or whether you're having treatment for something, or uh whether you have hypermobility or any of those single factors. It's how they interact with each other and how this makes you feel as a human. And that is the really crucial part because that subconscious feeling and the somatic responses that go with that are often what then start the cascade of issues with the voice.

Speaker 11:34

So you're really pointing towards the, as you say, the subconscious and the somatic responses. So we're really treading into the sort of psychological territory here and what effects those kind of responses might start to have to compound what may have started as a as a a medical thing or a um you know a biological thing.

Whole-Person Factors And Intake Approach

Speaker 1 12:00

I think when you're dealing with a human, you're always having to take into account the psychological. Always. And whether you're dealing with um a very clinical situation, I mean I I work in a hospital voice clinic every two weeks, and it's a hospital and it's medical, and it's run by a surgeon, and it's very clear what they're looking for and how how we're looking for it. But even so, every interaction is a very human one, and it it all depends on how that person walks into the room and who they bring with them, and whether they are struggling to move, whether they are maybe shaking a little bit, maybe you know, you're looking at all of those things and treating that human as a whole person rather than a collection of symptoms or a list of of tick box, you know, age, sex, etc.

Speaker 13:05

etc. And perhaps no more so than with voice, because actually voice um I I guess a lot of the people that come to see you are in any case people who are very invested in their voices because it's part of their professional livelihood. But anybody, the voice is is uh so wrapped up with our whole identity and who we are and how we express ourselves. It's uh really it goes very deep and it's also a very complex mechanism, isn't it?

Speaker 1 13:36

It is extremely complex, and it's internal, it relies on so many different variables to to produce sound. Uh, you know, we've it's not just the the very simple version that we're taught uh in pedagogy lesson number one, which is where you've got the breath coming through into the larynx, which makes the sound, and then into the vocal tract which modifies the sound. It's not that simple at all. It's a lot more complicated than that. And there's an awful lot we don't know.

Speaker 14:10

Well, yes, I was going to say we still uh discover things, decide things, undecide them, uh change things, and then of course we've got new territory as as uh the the the neuroscience becomes more acutely detailed and and more theories and suppositions are made around that, and everything's shifting all the time, really, isn't it?

Speaker 1 14:35

Isn't that exciting?

Speaker 14:37

Thrilling, it's endlessly fascinating.

Speaker 1 14:40

Just when you think you've got a hold on it. Yeah, somebody comes up with a new theory, or there's a new bit of research published, and it throws everything up in the air, and you think, right, I'm gonna have to rethink this. And I love that. I think life would be terribly boring if we knew how it worked.

Speaker 15:02

Well, we're going to take a short break there. We've set the scene, we've talked about the complexity of the voice, and next we're going to discuss Ginevra's paper that she's just published with Stephen King, and it's research into an idea around guarding, which we're very familiar with in physiotherapy, perhaps, when we have an injury and the body starts to guard and hold on to muscles around that, which can lead to added pain, in fact. But what might this mean for voice users? And we're going to also have a look at some of Ginevra's strategies to release some of that guarding, some of the more playful tactics. I hope that uh people will find this really interesting because I think we're going to go into a bit of a deep dive now about your paper, if that's okay with you, The Guarded Larynx, because I've just read this and spent the last few days really, really absorbing it. And I think it's a really interesting viewpoint that you and Stephen have come up with. Do you want to just start off by introducing what brought you to the guarded larynx as a term and how this the the main point of this piece of research?

Psychology, Somatics And Clinical Context

Speaker 1 16:16

It's an idea that isn't new. It's an idea that's been around for a long time, and uh it hasn't yet been really consolidated in terms of voice and larynx. So that was our main drive, as it were, to draw together all of the threads from different areas and relate them to larynx. And of course, the response has been, well, of course, it's obvious. It's obvious, it makes complete sense. And it's like, yes. No one, no one did it before. So it's rather lovely that it is obvious. But the idea of guarding is that it's um our response to fear or pain or discomfort or um being unsure. And it's to do with something in our bodies, but then it can be how our bodies are relating to everything else around us. So a simple explanation of guarding might be if you hurt your back, if you hurt your lower back by and and anyone who has lower back problems knows that you can just turn around and pick something up off the floor and hurt your back. You might do something a little bit more energetic or a little bit um more unusual, but it's often the surprise things, you know, getting out of the car in a funny way, and you you pull your back. What then happens is you have pain in your back, and you have a sort of you may have a constant pain all the time. You'll certainly have pain when you move. And instinctively our bodies say, ah, pain, warning, you've got to stop doing anything that's gonna make this worse. And our immediate response is to then stop moving, or to move in a way that doesn't increase the pain, so we might stiffen up and move in a in a way that is uh feels as if we're protecting ourselves. And what is actually happening is that we are doing the very opposite because we are stopping our body from moving and stretching and dissipating the holding patterns that are coming in, and moving through those and working through those gently, carefully, um often in a in a sort of ordered procedural way, moving through those will eventually dissipate that pain completely and it'll go away. So our instinct of how to protect ourselves, listening to your own body, is not always the best way.

Speaker 19:19

It's do you know that resonates hugely, and my own personal experience of this fairly recently was after a sort of minor bit of surgery. It wasn't anything uh too too traumatic for the body, but nonetheless, it was an invasion. Any surgery is an invasion of something external into your body. And so uh I was asked not to drive for a period afterwards, and I was desperately keen to get back into my car and drive. And I had to uh I I I felt that you know I I would be ready to do so before the the time that they said it might take. So I went back in to see the nurse and I and I said, I feel fine. Can I drive? And she said, Well, you're still guarding. And she did use that term.

Speaker 1 19:58

That's interesting. Um

Speaker 20:00

It was, yeah. She said, You're still guarding. And so that was to me the incentive to go away and jolly well get moving. And I went back four or five days later and said, Now can I drive? And she said, Yes, you can. But it was, but I thought, you know, it it was so very deeply unconscious. I wasn't aware that I was doing that. But she could straightaway see that my movement was just compromised because I was protecting that part of my body that had undergone that little bit of an invasion. And it took something very conscious from me, not just doing because I was already doing the exercises that they'd said, but I really had to think about okay, I'm going to be loose, I'm going to be loose. I had to really work at it. But I had a very good incentive.

Complexity, Uncertainty And Evolving Science

Speaker 1 20:45

Yeah. Yeah. And you knew from your experience, as soon as that term was used, you you thought, aha, now I know, yes. Yes, quite, I know. I must, yeah. And and I I have found the same. I've been exploring the same ideas myself with um with movement and and yoga practice. And when something feels you know stiff, it's going in a direction it doesn't want to go, I have to override my instinct and say, well, is this a safe direction to go? Can I just let go?

Speaker 21:19

But also being aware that perhaps it isn't. So you have to ask yourself the question, you know, making sure.

Speaker 1 21:24

And and be ready to release completely, but then rescue yourself if it isn't safe.

Speaker 21:32

So if we think of the the guarded larynx, guarding in terms of um voice, uh where might that take us? I mean your paper explores in great depth uh the the literature around guarding more generally, but then when you come to talk about the the guarded larynx, you've offered a lot of insights into some quite deep issues that lead to voice problems. We've talked a bit about psychology, and of course, Stephen, your co-author of that paper, is a psychotherapist and has come very much at this from that perspective. Would you like to say a little bit more about that psychological aspect of voice loss?

Speaker 1 22:15

Well, this is an idea that I think I've been exploring relatively recently in my career as a as a singing teacher. And that is the the impact that uh other people's behaviors and our surroundings can have on us and our responses. Um for example, uh as a singer, maybe I would have been in rehearsals. I mean, I can remember occasions like this, rehearsals of small groups or maybe stage rehearsals, and a conductor or director will make a comment or a look or a hand gesture or something that suggests that what I was doing wasn't right. And my response would be to hold up, to pull back and be worried, be fearful, try not to do it again, try and understand what was going on. But it would be very much a withdrawing, a withdrawing and a holding back. And that withdrawing and holding back is not, it goes against everything we need to do to free the voice and to keep moving. So that little response, which I think probably every professional singer has experienced at some point, can trigger that unhelpful reaction in the performer.

Speaker 23:49

So almost what you're saying is that that that that uh sort of negative feedback in the moment can make you uh effectively hold and guard in a way that then causes some kind of blockage in what is a natural flow. Is it something around that?

Introducing The Guarded Larynx

Speaker 1 24:06

It's holding, it's muscular holding patterns, which are very straightforward physical manifestations of this. And those holding patterns mean that we are not moving the system as flexibly as would be more helpful. Yeah, we need to be able to be really flexible and responsive in this system that we've already discussed is has so many variables. We can't control, we can't control the air pressure over time, we can't control the position of the larynx, we can't control the parts of the back of the throat that we can't even feel. You know, we that all of this we're relying on other systems and other responses and emotional drivers and all of those different variables to respond in a flexible way. And as soon as we hold a bit, as soon as we hold a bit, then that flexibility goes and we have to find a workaround.

Speaker 25:11

Yes, and so when we start to hold and we find a workaround, we're going to be devising a new system which may not be the optimal system, is that the the point of the thing? Okay.

Speaker 1 25:24

So we then develop compensatory strategies which get us through in the moment, but they then become habit. And we don't realise that we've done that. We don't we may be completely unaware of the initial trigger for this, and we develop a compensatory strategy that gets us through in the moment, and then that becomes a habit, and then the next issue or problem or comment that is made will add another layer onto that. So these are layers and layers and layers. And with people and their voices, this isn't just our professional life. It can go back to childhood being told to be quiet. It can be told that you don't know what you're talking about, shut up. It can be an older sibling telling you that you're talking nonsense or that you you need to stop talking. I mean the the the number of children who are shushed.

Speaker 26:26

Yes, and I think you know ch the I I've come across this a lot with performing artists, that they're often people who have got um a strong communication need or driver, and and so as children they may well have been uh told to to pipe down to to to not draw attention to themselves, to that they're showing off uh those kinds of comments which can really uh lead people to have to change what they do to fit in.

Speaker 1 26:56

Yeah, yeah. And that's in children, and then we've got adolescents who go through a whole identity exploration which is often out of balance in a in time, but you know, they may have really heightened emotions and they don't have the cognitive uh rationale to deal with that. And so behaviours and feelings and your sense of who you are and how you relate to everybody else is often a bit all over the place. And that is very much uh affecting the voice.

Speaker 27:33

Yes, and I suppose physically as well at that age, everything's traveling in in different speeds and nothing's kind of it's not that everything grows at the same pace together. So hen hence the bumping into things and general clumsiness of uh adolescents.

Speaker 1 27:49

Oh, totally, totally. And there's again, there's a lot we don't know. You know, we know that teenage girls often have breathiness in the voice, that there's a uh that closing the vocal folds in higher pitches can be more challenging for girls at a certain age. We don't know why. There's theories, there's conjecture, but we don't really know what's going on. It's probably a mismatch in growth patterns.

Guarding Explained Through Body Pain

Speaker 28:15

Hmm. Yeah. So I was thinking about when you were describing the uh the the these layers of guarding, these layers of um tightening or workarounds and compensatory mechanisms. Of course, when we're talking about the voice, it's really hard to see all of this because it's a lot of it is happening internally with an a coordination of a lot of different muscles. We do see external evidence of inappropriate tension, for example, if somebody's got a very, very stiff shoulder and or their heads on one side when they sing. You can see things externally, but there's a lot going on that you can't see. And I suppose for somebody who may not be familiar with talking about the voice in this way, perhaps a parallel uh is to think about an athlete who is really good at a tennis player who's really in flow. And often commentators will talk about them being loose, about them, or about a tennis player where things aren't in flow when they're not going very well, being kind of tight or tightening up. So we do see it in in athletes, and when you have experience of looking at people speaking and singing over time, you do see it. You can see where imbalances start to play out. But I think it can be quite difficult to put your finger on where those compensatory patterns are happening because it's so complex and so within.

Speaker 1 29:39

And and I this is where I just explore and play, and we'll make noises, we'll move around, and I I tend to start with just making simple noises and and movements and seeing and hearing what is possible and what the limitations might be, and asking all the time how it's feeling and whether it feels different, whether they like it, whether it's reminding them of anything. You know, there's all of this questioning and talking all the way. And it's often when you're halfway through, or you've done quite a lot of singing, then suddenly there'll be a a memory that comes back of something that happened in the past, or an explanation. And I'm a great one for the story. I love trying to uncover the story, and of course, you never do uncover the whole story. You can't peel back every layer of everything that's ever happened to you in your life, but you can peel back some of the more influential and more salient things that have been major influences, all the people believe are major influences. I mean, this is all to do with her with her own experience, it's not to do with my judgment of their life.

Speaker 31:06

Exactly. And I think this is where my uh as a as a coach, this this uh an executive coach, this um, which is of course my other strand in life, uh, this really plays out because I think uh people when they have the when they're being truly listened to, when they're really being heard, that gives people the space to make connections in their story that they might not otherwise have made. And I think that that um is a great strength of what you do and and what um I hope I've learnt to do through the training that I had with vocal health education. Perhaps the most significant part of that training was the counselling skills course. Because learning to really listen to somebody and give them the space to actually think and actually uh relate what they're doing and feeling physically to stories, to the history, to the past, to the present. I I think it's incredible what comes out in an hour-long session, and it can be still 40 minutes into a session where someone will say, Oh, I never thought to mention, but actually, and some key part of the story will come forward.

Speaker 1 32:20

And sometimes it might be four hours in, you know, that you're you've done many sessions and something comes out that they hadn't really made the connection because they'll go away and they'll think about it, and then they'll come back and say, Do you know what?

Speaker 32:34

I've been thinking. I noticed you used the word play and you've used the word fun. And I think uh when you first talked about the kinds of instructions or responses that might create the guarding patterns in the first place as being usually critical, and then you're talking about your own approach being about play and fun. There's obviously something in there about judgment, isn't there? Tell me tell me about that.

Applying Guarding To The Voice

Speaker 1 33:02

Really, really important. Um I the noises I will get people to to make and to work with are normally noises that aren't really singing. Um they they're just noises, vocal noises, and that means that they are not associating them with getting it right. There's no judgment there. There's no and that might be self-judgment or perceived judgment from others. It's really important just to bring back that idea of play exploration, and and also to when you're messing about, you make you you get it wrong, and the noises might crack or splurge or go out of tune or whatever. And it that's fun and that's important. And I'm always celebrating that. Even if somebody then you know suddenly gets a frog in their throat or put or a sensation of a frog, I say, that's great. That means things are moving, things are shifting. You know, every every change like that is something to be thankful for and to go with.

Speaker 34:12

It I suppose it mitigates, doesn't it, against that uh con constant reiteration of the same kind of narrow pathway to get a perceived ideal result, which in the end, what you're doing is just rehearsing again and again one pathway. Uh, and if it's not the right pathway for you and for your vocal efficiency or for your artistic efficiency, really, efficiency is not a great word to use, perhaps with artistic, but artistic expression, it you're narrowing your field, really, aren't you? Uh whereas what you're describing is offering many different versions of how a sound might be able to be made, and perhaps after that the brain might select something different that it hadn't thought of before. Yeah.

Speaker 1 35:00

You're just giving options. Just giving options to the brain that you could do it this way or that way. And we know actually with learning that this is much more effective for um a perfectly healthy functioning brain and voice. That that if if you're going to learn a skill, just rehearsing the same thing over and over again is very limiting and not very effective. And give it a bit of variability, give it a bit of challenge, mess things up a bit, do it backwards, forwards, upside down, you know, bigger, smaller, higher, lower, louder, softer, all of those.

Speaker 35:40

Yeah.

Speaker 1 35:42

Bring in all of those variables and challenges. And your brain will find the best way to produce what your imagination is intending.

Speaker 35:54

So you will be able then to be a more expressive singer, actually, as well as a more uh proficient singer, technically. Yeah. Yeah.

Speaker 1 36:07

Absolutely. In individual expression. I mean, isn't that what we aim for with artistry?

Speaker 36:14

It truly is. And I I think I think that what I'm picking up hugely here is uh something that ties in for me with work around self-compassion for a singer or a speaker or a public speaker, anybody who has to do things in high-stakes moments. I think this really permissive approach is uh a very compassionate approach as well, because it's taking that judgment away.

Triggers, Judgement And Holding Patterns

Speaker 1 36:45

Yeah, yeah. And that is it's all related, Nikki. It's all tied in because what's got them in the pickle in the first place is fear. And um we can talk about the fear avoidance model, which is a very useful model to consider in this, and it's when you have an onset of pain, and then you experience the pain, and you either catastrophize or you don't catastrophize. So when you experienced your guarding, which wasn't necessarily pain, it was just a bit of holding and a bit of change in the way that you were using your body. You could have gone away and thought, oh goodness, I'm still doing that. I'm got, I'd better be really careful, I'd better stop moving so much. Or you could have gone away and and did what you did, which was, okay, let's see what I can do and and get moving, get going, get using it. Um, don't be fearful. And if you do go around down the fear model and the catastrophizing and the holding, then what happens, of course, is the pain increases and things get worse and worse and worse. Why are you doing that? You're not doing that because you're stupid or because you are faulty or because you know any of those. You're doing it because you need to feel safe. And I think that is crucial for people to realize that they've got themselves in a pickle because they've been aiming to keep themselves safe.

Speaker 38:30

And at this point, we're going to draw to a close the first part of this conversation, but I hope you'll join us for part two. We talk a little bit more about that fear avoidance model and we talk about uh the hypersensitive larynx, we talk a bit about psychogenic voice disorders, complete voice loss, really have a delve into all of that. And we also talk, of course, about our own boundaries as voice coaches because we are not psychotherapists ourselves, but we, as it would be abundantly clear if you've been listening to this, we are walking into psychology the minute we start to talk about voice. So, where is our scope of practice and what are the boundaries around the conversations we can have with a client who comes in with distress around their voice? So please do join us for part two. There's lots more juicy stuff to hear. You've been listening to VoiceCast with Nikki Kennedy. For me, voice has always been more than just sound. It's presence, connection, music, transformation. I hope this episode has offered something to carry with you into your own conversations, into your own story. So drop us a line, be in touch, and until we meet again, I hope that your voice finds the space it needs to be really heard.