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Grace Weber Johnson
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November 2004
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UMI Number: 3173558
Copyright 2004 by
Johnson, Grace Weber
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Title o f Dissertation The EtTects o f Childhood Sexual Abuse
on the Adult Singing Voice
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Date o f Oral Defense November 12,2004
’h y / '- v
.....
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This Lecture-recital is accepted by the Graduate Music Faculty and Doctoral Committee
of Shenandoah Conservatory in partial ftdfdlment of the requirements for the degree of
Doctor of Musical A rts in Performance
Date
Shertandoah Conservatory
1460 University Drive, Winchester, VA 22601-5195 | 540-665^600 | FAX: 540-665-5402
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ABSTRACT
By
explored the relationship between the adult singing voice and childhood sexual abuse
(CSA) through case studies and a review o f the literature in Vocal Pedagogy,
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Psychology, Speech-Language Pathology, and Music Therapy. Although a search of the
literature yielded no reference to the effects of CSA on the adult singing voice,
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information in each discipline regarding separate components o f CSA and/or singing was
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examined. From this information, effects of CSA on the singing voice were inferred.
These inferences were compared to essential themes derived from case studies.
The research indicated that adult singers with a history o f CSA could present
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could be impacted by the act o f singing. It was determined that to be prepared for the
professionals who teach (treat, coach, etc.) singers with a history o f CSA would benefit
of the dynamics o f posttrauma response. Curroitly, singers seeking help must bridge
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optimal treatment strategies by supporting an interdisciplinaiy exchange of information
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To Bill
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ACKNOWLEDGEMENTS
The heart of this research rests in the testimonies o f the case study participants. I
was moved by their courageous generosity and grateful for their immeasurable
contributions.
The successful completion o f this study was due to the unflagging vision and
support o f my voice teacher, mentor, and dissertation committee chair Dr. Janette Ogg,
Professor of Music-Voice. I express my heartfelt appreciation to her. She and the other
committee members represented four departments from two different schools o f the
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university with a level o f collegjality and scholarly intercourse that exemplified the very
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spirit o f interdisciplinary communication inherent to the purpose o f this research. They
presented to me a united front o f challenge and support. It has been my privilege to work
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under their guidance. I am indebted to each: Dr. Steven Cooksey, Professor o f Music-
Organ/Church Music; Dr. Kathryn Green, Associate Professor o f Voice; Dr. Michael
Rohrbacher, Associate Professor o f Music Therapy; and Dr. Gretchen Stone, Professor of
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Dr. Charlotte Collins, Dean o f Shenandoah Conservatoiy; Dr. Danny Phipps, Professor of
Music and Associate Dean o f Shenandoah Conservatory, and Dr. Adrienne Israel, Vice
Guilford College for assisting me with triangulation: Dr. Kathryn Adams, Dana Professor
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I am fortunate to have a long list o f people to acknowledge. They appeared when I
most needed them and served in many capacities. For their assistance with reading the
work in progress, I am grateful to Jim Bumgardner, Carol Hoppe, and Sue Keith. For
their encouragement and advice I thank Dr. Harold Andrews, Dr. Glenn Busch, Kathryn
Cloyd, Barbara Crowell, Dr. Jerry Godard, Colleen Hartsoe, Judy Hueston, Ellen Linton,
Ernest McCoy, Dr. Lisa McLeod, Dr. Ellen Markus, Evelyn Moralez, Clarajo Pleasants,
Teresa Radomski, Carol Stonebumer, Dr. John Stonebumer, Kathryn Beam Troxler, and
I am gratefiil for ongoing encouragement from my husband Bill Johnson and our
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daughters Sarah Bowen and Molly Johnson; the sustaining memory o f my parents
Macbeth and Helen Weber that refreshed me throughout this venture; and the long-ago
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memory o f learning songs from my sister Elizabeth Burford.
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Written permission was obtained from Carolina Biological Supply to use their art
piece titled Human Respiratory System (Larynx and Trachea) and from Meribeth Bunch
(Dayme) to use ihustrations from her text Dynamics o f the Singing Voice T ‘^ ed., 1999.
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LIST OF MGLMES AND TABLES
Figures Page
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7. Representation of voice lessons for a healthy student.......................................... 148
11. Representation of voice lessons for a indent who has trouble with authority... 151
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Tables
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TABLE OF CONTENTS
Abstract...............................................................................................................................iv
Acknowledgments............................................................................................................. vii
Chapter page
1. Introduction to the Study.................................................................................... 1
Purpose........................................................................................................3
Methodology............................................................................................... 4
Design............................................................................................. 4
Participants...................................................................................... 5
Procedure......................................................................................... 5
Data Analysis...................................................................................6
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Limitations o f Study.................................................................................... 8
Definitions; Sexual Abuse; Singing................................. 8
Definition o f Vocal Pedagogy Terms..........................................................9
Definition o f Psychology Terms............................................................... 12
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Organization o f Literature Review and Chapters.......................................15
Areas o f Technique.................................... 31
Classification.................................................................................39
Health o f Singer.............................................................................40
Role o f the Brain: Vocal Pedagogy/Psychology Literature...................... 43
Voice as Self: Vocal Pedagogy/Psychology Literature.............................47
Timbre: Speech-Language PathoIogyA^ocal Pedagogy Literature........... 48
Therapeutic Use o f Voice: Music TherapyA7ocal Pedagogy Literature... 50
3. Case Studies.............. 54
Procedure....................................... 54
Themes.......................................................................................................56
Physiological Problems with Singing........................................... 56
Physical Response to CSA............................................................ 58
Reaction to Feedback: Visual, Aural, Teacher/Coach.................. 59
Relationship with Teachers........................................................... 61
Correlation between CSA and Singing......................................... 62
Effect of Therapy for CSA on Singing......................................... 64
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Pattern of Awareness.................................................................... 65
Fear of Success ;....................................................................... 66
Performance Anxiety.................................................................... 67
Trust.............................................................................................. 67
Pow er............................................................................................ 68
Sex and Singing............................................................................ 69
Teaching........................................................................................69
Benefits o f Singing; Problematic and/or Therapeutic................... 70
Summary.................. 71
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Altered Emotionality..................................................................... 90
Dissociation...................................................................................93
Impaired Self-Reference............................................................... 94
Disturbed Relatedness................ 95
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Avoidance......................................................................................96
Somatic Response to CSA........................................................................ 97
Overview of Somatoform Disorders............................................. 98
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Selected Disorders.......................................................................103
Body Im age................................................................................. 107
Trauma Memory...................................................................................... 110
Neurological Considerations....................................................... I l l
Psychological Considerations...................................................... 114
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Somatic Considerations................................................................118
Philosophy o f Trauma Treatment............................................................ 122
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Scenario IV: Somatoform Disorder.............................................150
Scenario V: Relationship with Teacher/Trouble with Authority. 150
Recommendations for Voice Teachers....................................................151
First, Do No Harm.......................................................................152
Proceed with Confidence............................................................ 156
Recommendations for Further Research.................................................156
Conclusions............................................................................................. 158
References....................................................................................................................... 161
Bibliography.................................................................................................................... 168
Appendices
A. Questionnaire 1......................................................................................... 184
B. Questionnaire II........................................................................................185
C. SU HSRB Informed Consent Long Form.................................................187
D. SU HSRB Consent for Voice Recording..................................................190
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E Permission for Copying from Carolina Biological Supply Co................. 191
F. Permission for Copying from Spring^-Verlag, W ien.............................192
G. Permission for Copying from Meribeth Bunch........................................ 193
H. Revised Permission for Copying from Carolina Biological Supply C o.. 195
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C hapter One
Research has shown that childhood sexual abuse (CSA) can silence the voice-
both the figurative voice (the self, the expression o f personal identity) and the actual
(physical) voice. When the silenced voice is that o f a singer, issues o f both CSA and
singing are compounded because o f the cyclical nature o f vocal and psychological
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singer’s sense o f self is threatened. They explain:
The grief of a voice disorder, with its accompanying identity crisis, is fiirther complicated
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when symptoms of CSA are present. Psychotherapies for CSA can compromise the
singing voice; vocal therapies designed for “r e ^ la f ’ singers may be inappropriate for
Currently, a singer seeking help for vocal disturbances related to CSA must take
the responsibility to bridge disparate disciplines. (This assumes that the singer will have
acceptable level o f vocal dysfunction differs for singing and speaking. (For example, a
^Deborah Rosen and Robert Satalofl^ Psydhology o f Voice Disorders (San Diego:
Singular, 1997), 2-3.
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slight cold may be an annoyance for most people, but for a singer it could be life
make that variance clear to medical doctors, so must they educate other professionals
CSA and/or singing among the disciplines o f Vocal Pedagogy, Clinical Psychology,
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decisions. IE
The need for research on CSA and singing is great, but the risks for harm are
high. Any research on a sensitive topic such as CSA carries a potential for harm, but one
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that combines two emotionally charged areas—^voice disorders and CSA—is especially
singers with voice disorders connected to CSA—disorders that could counteract the
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healing aspects of singing when they are most needed. Until research is undertaken,
singers are denied optimal treatment/therapy. Thea-efore, the potential benefits o f research
^ Vocal pedagogue Daniel Boone listed the following specialists who might be of
help to singers: Allergist, Audiologist, Choir Director, Drama Teacher, Endocrinologist,
Inhalation Therapist, Otolaryngologist, Pharmacist, Physiatrist, Plastic Surgeon,
Prosthodontist, Psychiatrist, Psychologist, Speech-Language Pathologist (a.k.a. Voice
Pathologist), Speech Therapist, Voice Coach, and Voice Scientist. Daniel Boone, Is Your
Voice Telling on You? 2d cd. (San Diego: Singular, 1997), 174-5.
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on singing and CSA—for singers, voice teachers, and health professionals—outweigh the
risks.
This study has stemmed from my experiences as a singer and as a college voice
teacher, where I have encountered singers with voices compronoused by the complexities
of CSA. During my nearly two decades o f teaching voice, I have come to a gradual
realization that singa*s who confide a histoiy o f CSA seem to share common but
perplexing difficulties with singing and with studying voice. One dramatic incident, a
student’s negative emotional response to success with breathing, stands out as a clear
indication for the need to understami the effects o f CSA on the singing voice. My search
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of the literature has been to no avail. With the exception o f Music Therapy studies on the
voice as a healing agent for effects o f CSA, to date I have found no research on the
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effects of CSA on the singing voice. This study is based on (1) case studies from
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interviews with voice teachers who have a personal history o f CSA and (2) literature in
Purpose
The purpose o f this study has been (1) to e?q)and the knowledge base regarding
the effects of CSA on the adult singing voice, by describing the experiences o f singers
review; and (2) to encourage communication among professionals (i.e. voice teachers,
singers with voice disorders stemming from CSA. In order to promote communication
and to serve the diverse audience o f the second part, the study provided educational
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information (purposely non-esoteric and accessible) about Vocal Pedago^ (the
Methodology'*
Design
described by Wheeler (1995)^ and Creswell (1998).^ The sensitive nature of the research
dictated the decisions for design. The focus to derive meaning and essence from abusive
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experience was best served through a reflective, phenomenological approach—obviously
post-factum. The study integrated (1) case studies based on interviews with participants
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and (2) an interdisciplinary literature review. The format and writing style o f the report
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followed guidelines specific to qualitative design as described in Wolcott (1990).^
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^ John Creswell, Qualitative Inquiry and Research Design: Choosing Among Five
Traditions (Thousand Oaks, CA: Sage, 1998).
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Participants
CSA. They were volunteers who learned o f the study through word of mouth in
professional (i.e. school, confa-ence etc.) settings. From the pool of participants, a
convenience sampling was narrowed to four singers who were also voice teachers. All
had advanced music degrees; all were female; all had undergone psychotherapy for issues
related to CSA, and their ages ranged from early thirties through mid-fifties.
Procedure
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The first part of the research was comprised o f four case studies. Voice teachers
the value of the research; confidentiality; possible harm; and the option that they could
refiise to answer selected questions, stop the interview at any time, and withdraw from
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the research at any time. This information is included in the Shenandoah University
Informed Consent Long Form, which follows the guidelines presented in the Shenandoah
The second part o f tte study was an interdisciplinary literature review. Research
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the current body of knowledge in Vocal Pedagogy on the mechanics and structure of the
Data Analysis
Narratives from the interviews were transcribed to protect the identity of the
participants’ voices. The shortest interview was forty-five minutes; the longest was nearly
three hours (including periods o f rest). Three participants answered all o f the questions;
one answered only nine o f the second set and asked to end the interview before
completing the questionnaire. Each participant was given the opportunity to request that
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some of her testimony be omitted. Two chose to do that. With their permission, their
answers were recorded for later transcription. The recordings were listened to only for
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transcription; no attempt was made to use the recordings to determine emotional content
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from vocal timbre.
narratives. Later, in two additional meetings, the readers and I met to establish agreement
on themes. Consensus was reached easily, entailing little debate. I had anticipated four
themes, but had not shared that information with either the participants or the readers.
They were (1) mechanics o f singing, (2) psychosomatic response to CSA, (3) reaction to
feedback, and (4) correlation between CSA and singing. The readers also chose those
themes but advised that the label o f the second be changed to “physical response to
CSA” It was agreed that the word “physical” was less problematic than “psychosomatic”
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because of controversy in the field of psychology regarding the meaning of
(reaction to feedback), and fourth (correlation between CSA and singing) themes and
derived six additional ones. This brought the total number o f themes to fourteen, which
because the content o f the narratives that we had labeled for one turned out to be identical
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to the other. Furthermore, I grouped the six additional themes (8-14) under two
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categories: emotions and singing. (These categories were not determined in our
meetings.) Finally, rather than attempting to avoid redundancy, I strove to report each
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theme with examples fix>m the narratives. But identification o f more than one theme in
several portions of the narratives required some repetition. The themes derived are as
follows:
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(Physiology)
1. Physiological Problems with Singing
2. Physical Response to CSA
(Reaction to Feedback)
3. Visual, Aural, Teacher/Coach
4. Relationship with Teachers
(Emotions)
8. Fear of Success
9. Performance Anxiety
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10. Tnist
11. Power
(Singing)
12. Sex and Singing
13. Teaching
14. Benefits of Singing: Problematic and/or Therapeutic
There were several limitations to this study. (1) With few exceptions (all noted)
the singing technique described was classical. This decision was prompted by the
primarily classical orientation o f the j^rticipants, my background, and the current Vocal
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Pedagogsf literature. (This singing technique and the term “classical” are explained in
Chapter Two.) (2) The focus was primarily (but not entirely) on the experience of
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females. A greater amount o f literature exists regarding the experience o f CSA for
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females than for males* and all o f the participants for this study are female. (3) The
research was limited to the experience of adults^—^as singers and as survivors of CSA.
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Defmitinns
Sexual Abuse/Singing
The terms sexual abuse and singing have gradations o f meaning. The following
* Chantal Jolly, “Breaking Out o f Silence; Breaking into Song: A Music Therapy
Model o f Practice for Witnessing the Healing o f Adult Survivors o f Childhood Sexual
Abuse” (M. A. thesis. Open University o f British Columbia, 1998).
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the Oxford Dictionary o f Psychology and a more specific
description by psychologist John Briere. The Oxford Dictionary o f
P sycM ogy defines sexual abuse as “the subjection of a child or
other vulnerable person to sexual activity liable to cause physical
or psychological damage.”^ Briere defines childhood sexual abuse
as . .sexual contact^ ranging from fondling to intercourse,
between a child in mid-adolescence or younger and a person at
least five years older...
Singing/Singer; Unless otherwise noted, the use of the term singing (or singer) will
denote a “classical” style or technique. (This technique is covered
in more depth in Chapter Two.) It should be kept in mind that a
possible change o f data could result with a non-classical singing
orientation.
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During the latter part o f the twentieth century, voice teachers were encouraged to
However, singers still sing by sensation and often respond to the vocabulary o f imagery.
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Therefore, this vocabulary list includes both scientific and idiomatic terminology since
both are used traditionally in voice lessons. Discussing a singe’s complaints might entail
a “bilingual” conversation.
abduct: To open.
John Briere, Child Abuse Trauma: Theory and Treatment o f the Lasting Effects,
Interpersonal Violence: The Practice Series, ed. Jon R. Conte (Newbury Park, CA: Sage,
1992), 4.
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adduct; To close.
appoggio- “Ah-pah-joe.” Italian for “to lean against.” The perfect balance of
subglottal breath pressure to vocal fold adduction. (See glottis.)
approximate: Touch.
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beyond the first passaggio without the use of cover or vowel
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Bernoulli effect: Vocal folds are drawn together because o f Bernoulli principle—^air
pressure will be less when air flows through a constricted area.
breath support: The use o f abdominal muscles to delay the ascent of the diaphragm
during phonation. (Also called “support.”)
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flutter: Very rapid vibrato. Considered a vocal fault.
PVCD abbrev.: Paradoxical vocal cord disorda"; condition in which the vocal
cords adduct during inhalation causing a wheezing sound that
mimics asthma.
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lift.
register: An area o f the voice in which all o f the pitches have the same tone
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quality and are executed with the same mechanism. Opinions vary
on the number o f registers in a voice. The ideal is to blend them so
that they sound like one.
singer’s formant: The ring in the voice; a formant frequency at approximately 2800
Hz. for males and 3300 Hz. for females that occurs when
resonators are the correct shape for the pitch and vowel.
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