No Space to Sing: A Narrative Inquiry into the Experiences of Classical Singers with Primary Muscle Tension Dysphonia

This study was designed as a qualitative narrative inquiry study into the experiences of classical singers with Primary Muscle Tension Dysphonia (PMTD). PMTD is defined as Muscle Tension Dysphonia (MTD) without organic or neurological factors. In the population of professional voice users, PMTD is typically associated with occupational/behavioural causes. A review of the literature shows that occupational disorders are associated with stigma in the classical music community, that research on PMTD in the demographic of singers is sparse and often broadly defined, and that PMTD is not well-represented in the vocal pedagogy literature. Additionally, PMTD may present differently in classical singers than in other populations of singers, or in the general population. The gap in the vocal pedagogy literature, and the stigma present could contribute to students developing PMTD and could cause delayed diagnosis for singers. Further, living with undiagnosed PMTD could have a grave impact on the ability to sing and on mental health. Narrative inquiry was chosen as the most appropriate qualitative approach for an early study in this population. Eleven adult classical singers with PMTD diagnoses – in career stages from still undergoing undergraduate training to the midst of major international careers – were interviewed regarding their experiences prior to diagnosis, during treatment, and post-recovery. These interviews pursued a dual purpose: to discover emergent themes relating to PMTD in this population, and to create a space for voices to be heard that may have previously been rendered voiceless both by the disorder and the classical singing community. The many themes that emerged across participant experiences fell into mainly medical and vocal pedagogy categories. Without fail, participants were severely impacted by the disorder, often by stigma and isolation, and in a few cases by medical mismanagement. Both institutional factors, and specific voice technique elements (such as registration), in the current vocal pedagogy paradigm appeared to be causal factors in this demographic