Successful treatment of vocal fold palsy in a language different from patients and therapists mother tongue

Sabine Hofmann (sabine.hofmann@tin.it)

Studio logopedico ‘Mindworks’

Terni, Italy

Only two month after appearance of first symptoms the patient was correctly diagnosed and subsequently got taken into therapy. Not only voice quality was impaired but also respiratory problems and dysphagia for liquids were present, the sphincteric function of glottis in general was compromised. Muscle tone especially in the neck region and in the right arm was increased. No abdominal movements were visible during respiration.

Following Schlaffhorst-Andersen method in a first stage therapy focused on perception and regulation of muscle tone and respiration through passive exercises. Next step was conscious reaction on motor impulses. All exercises were proposed in the patient’s respiratory rhythm respecting the pause after expiration. In this way it was soon possible to observe positive respiratory reactions like deeper inspiration and sigh-like expiration. Voice exercises mired at perception of minimal sufficient force and maximum coordination (e.g. respiration – pushing/pulling impulses – phonation). In standing position impulses provoke reactions in regulation of balance, this ameliorates muscle tone, the patient got physically hold and supported. All these exercises having specific goals and being chosen according to individual condition do also have a more general meaning that regards relational aspects and variety of possible stress reactions by using indirectly the physical experience and non-verbal communication during exercises as basic concepts for unconscious metaphoric elaboration.

In part non-verbal communication may assure successful treatment even if patient and therapist come from different cultures, while gender difference is considered to be more critical.

Key words: vocal fold palsy, Schlaffhorst-Andersen method, therapeutical relation, non-verbal communication, metaphors