Voice and psychological: effects reciprocal in a patient total laryngectomized

Abstract

The voice is constituted in the subject’s history, and reveals individual marks and characteristics resulting from subjective experiences. In the present study, the focus lies on a peculiar pathological voice condition, in which the subject loses important structures of the vocal tract due to a total laryngectomy, a surgical procedure to treat some of the cases of cancer in this body region. Many studies have focused on the efficiency of the methods for promoting communication in theses patients, but there is a lack of studies regarding the mental issues involved in these cases. Therefore, the aim of this paper is to discuss the contents pertaining to the psychism involved in the vocal symptoms of a totally laryngectomized patient. This is a clinical qualitative study, developed as a case study of a male, 59 year-old subject, who underwent speech therapeutic intervention after a total laryngectomy. The interpretation of the data occurred in the interfaces between body, voice and psychism, and was subsidized by theory referentials from both Speech Language Pathology and Psychoanalysis. Results: The patient used the therapeutic setting to express mental conflicts associated to laryngeal mutilation, sustained by the speech therapeutic intervention of a biological and mental mindset, i.e., oriented by the listening to the subjective contents associated to the vocal symptoms. However, the mental conflicts generated by the irreversible organic condition prevailed, and this led to treatment abandonment. Conclusion: In spite of the failure to overcome organic mutilation, the patient was able to express and elaborate the suffering generated by his pathological condition, and this should not be excluded from the therapeutic proposal regarding vocal disorders.