#169. Insights and Strategies for Maintaining Vocal Health with Lori Sonnenberg

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Episode Transcription

Dr Marisa Lee Naismith  00:00

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Dr Marisa Lee Naismith  02:34

It’s Marissa Lee here, and I’m so excited to be sharing today’s interview round episode with you. In these episodes, our brilliant lineup of guests will include healthcare practitioners, voice educators, and other professionals who will share their stories, knowledge and experiences within their specialised fields to empower you to live your best life. Whether you’re a member of the voice, community, or beyond your voice is your unique gift. It’s time now to share your gift with others develop a positive mindset and become the best and most authentic version of yourself to create greater impact. Ultimately, you can take charge, it’s time for you to live your best life. It’s time now for a voice and beyond. So without further ado, let’s go to today’s episode.

Dr Marisa Lee Naismith  03:44

In this episode of a voice and beyond, we dive into the complexities of vocal health with our brilliant guest, Laurie Sonnenberg. Laurie is a Chicago based licenced speech language pathologist, clinical voice specialist and singing voice specialist renowned for her expertise in treating voice disorders. She is also the founder of Sonnenberg voice, a clinic dedicated to providing comprehensive voice care for speech, breathing and singing. Voice issues often stem from vocal fold injuries, overuse or inefficient use of the vocal mechanism. These issues can severely impact one’s ability to perform daily tasks, particularly for professional voice users, such as singers, educators, actors and public speakers. Lori’s clinic specialises in treating muscle tension dysphonia recovery from VA I see injuries, professional voice care, post operative voice recovery and addressing technical voice issues or singers. In our conversation, Laurie offers a detailed overview of what an initial consultation at her clinic entails, including the diagnostic process and treatment strategies. She emphasises the importance of prevention, and shares insights on how voice teachers can identify potential voice problems in their own voices and those of their students. Laurie also underscores the necessity of seeking specialist help promptly to avoid long term damage. Laurie highlights the importance of supporting singers through their vocal challenges. Rather than shaming them, debunking misconceptions about vocal pathologies across different genres. This episode is a must listen for anyone interested in voice health. Whether you are a professional voice user, or simply someone looking to improve and maintain your vocal quality. Tune in to gain valuable insights from Laurie Sonnenberg and learn how to better care for your voice. So without further ado, let’s go to today’s episode.

Dr Marisa Lee Naismith  06:48

Welcome to the show, Laurie Sonnenberg. It’s such a pleasure having you. How are you?

Lori Sonnenberg  06:53

Hi, Marissa. I’m doing great. Thank you. How about you today? I’m

Dr Marisa Lee Naismith  06:57

doing well, except my cat is meowing Charlie. He needs to know his lips. But no, it’s such a pleasure having you and there is so much information that I want to extract from you. I’m totally going to be geeking out. You’re Yeah, I’m

Lori Sonnenberg  07:16

excited. I can’t wait to geek out with you. Yes. So

Dr Marisa Lee Naismith  07:20

you’re the first speech pathologist that I’ve interviewed and I truly have a million questions. So let’s start unpacking you. Let’s start getting to know you, Lori, you are a licenced speech language pathologist, a clinical voice specialist, and singing voice specialist. And you’re based in Chicago, one of my very favourite cities in the US. And you’re also a soprano, you have you have a Bachelor of Music degree and a masters of music. There is so much to learn about you. So let’s start with and I love doing this with all my guests is finding out. Okay, so as a child, did you think and when did you actually figure out that? Okay, I’m not such a bad singer.

Lori Sonnenberg  08:12

Yes, I’m pretty sure I have memories. I don’t really, really have a lot of life memories that don’t involve thinking I have memories from such a young age thing. My whole family was musical both both sides of my family were musical. And my mom really wanted me to play piano and expose me to a lot of music growing up. And so I started studying piano very young as well about age five. But I got memories of doing solos and little music clubs and things even at that early age. I think my very first public Solo was preschool graduation. Somewhere Over the Rainbow. Oh, of course. What else? Yes. And my parents don’t have like a cassette tape of me singing it.

Dr Marisa Lee Naismith  09:03

Oh, I would love to hear that. You’ll have to put it up on social sometime.

Lori Sonnenberg  09:08

I know. That would be great, wouldn’t it? Yes. So So I did. I did a lot early on. Just thinking for a week. I grew up in a really small town in Northwest Louisiana. But surprisingly, we had a really robust music community. The music teacher, the national music teachers association had a club there. And so I had a my very best friend’s grandmother used to host these old timey salon gatherings in her front parlour with her grand piano. And I would go and seeing for all these these old ladies at the music club meetings and so that those are my earliest earliest memories of doing that, but then I really feel like church was where I started kind of being shaped as a singer and musician, it was a great outlet for me to play and and to sing. I started participating in choirs and so forth. And I had a choir director who took an interest in me, I was about 11 years old. And he went to my parents and said, There’s something here, like, you know, there’s something going on here, and we need to foster it. And so those were that was kind of how it all began, I started taking voice lessons and never looked back.

Dr Marisa Lee Naismith  10:28

Well, thank goodness for that. So you went on to study voice and vocal pedagogy formally, what happened? First, I know that you’ve done some teaching, you’ve had a performance, little performance career, you’ve done some teaching, and then you transitioned into speech pathology. What was that journey? Like? What order did all that happen in?

Lori Sonnenberg  10:52

You know, I started out like a lot of young singers who were gifted in in the classical realm. So I, my voice was really well suited to classical singing. And I was a high soprano. I was also really strong musicians, so I could learn and seeing very difficult music. And so I was really focused and motivated about just pursuing a big performance career in opera, right. I mean, that was what I thought I wanted to do. I would envision myself the Met and in Europe and galavanting about and singing and doing all and knowing and learning all the languages and, and that was really my focus for most of college, I was still pretty focused on that. But during college, I took my first pedagogy course, which is kind of unusual for undergraduates at that time, that was in the 90s. And it was an old book, but it had these hand drawings of the lyrics and the anatomy and physiology. And we started learning about injury ran, I never had injury and not I was fortunate as a singer to never have really struggled. But I had a lot of friends who were music education majors, who were struggling and getting diagnosed with nodules and different things. And so I was sort of observing all of this as a very young singer, and want to be teacher. So I tried teaching very young, I started teaching lessons when I was like, 19, which I would never want someone to do that now. But I look back and it was just a good fit. I, I was good at teaching music to young people. And so I use my piano skills, and just my budding skills as a voice teacher to you know, start playing around in a private studio setting with other voices, and realise, hey, I’m pretty good at making changes and the sound. Yes, you know, I can listen to them. And I can sort of internalise that and diagnose it by introspection, what do they need to change about what they’re doing to make it sound better, or different. And so I think I started doing that sets at such a young age and, and then when I went to my master’s degree, I was recruited for that degree by a professor named Norman spy v. And it was a new programme at that time, and they they there weren’t that many of them. Masters and pedagogy were just unheard of. And they recruited me for that gave me a teaching assistantship, and I just loved teaching. I was just I felt like I am born to teach voice. But I had a good instrument too. And so I was really torn. You know, I had it, I felt like maybe I had the chops for the performance thing, but I wasn’t sure. And I just couldn’t get the vocal injury rehabilitation piece out of my head. Sure. And I lived really close to Philadelphia at that time when I was doing that degree. And so I started observing and spending time and learn got analytic ology clinic.

Dr Marisa Lee Naismith  13:59

Well, so that opportunity came up for you very

Lori Sonnenberg  14:02

early, very early. And, and there weren’t very many, I really wanted to be a singing voice specialist. I didn’t want to do the speech pathology piece, I just wanted to do the singing voice specialty. But here in the States, you know, there are stronger lines, the somewhat between the practice of those things. And I realised after talking to people that I probably would not get to really be all that involved in the medical side of things. If I didn’t do the speech pathology degree. Sure, sure. And so I was still I was in my mentally 20s. And I said, you know, if I’m going to do this, this is the time and I actually gone on and started my doctoral work.

Dr Marisa Lee Naismith  14:48

Really, so you started. Well,

Lori Sonnenberg  14:51

I had started my document musical arts. Yes. And, and I just couldn’t get that I was envisioned In this role where fingers can have very specialised support for recovering from injury, yes.

Dr Marisa Lee Naismith  15:06

And isn’t it strange in life, sometimes you have that calling, and you can’t move away from it. That’s it. That’s all you want to do and nothing else and you can try other things. But when your hearts in something, you just have to go for it, don’t you

Lori Sonnenberg  15:24

that? That’s exactly right. And I think that that’s a great way to say that because that looking back, I do think there was just this deep sense of calling and, but I was scared, I was scared. I devoted my entire life to cultivating the craft of theming for my, for my own instrument. And I actually remember the day that I came home and officially said, Okay, I’m doing this, I’m leaving performance behind and making this this change here. And it was tough. I was depressed for a while it was the big thing to give up.

Dr Marisa Lee Naismith  16:03

But that would have taken a lot of courage, so good on you to make that call. Because look at you now, it’s all been worth that. Work. You’re doing such amazing work. Okay. Now, I want to ask here, and this may be a really ignorant question. What is the difference between a voice therapist and a voice pathologist? And is there a difference? into use of the same thing?

Lori Sonnenberg  16:33

I think we interchange them a lot. He especially here in the States, I think everyone kind of calls themselves something just a little bit different. I use voice pathologist sometimes because I am involved a lot in the diagnostic process. And that that pathology diagnosis of and I don’t know it it for me, it really feels like it gives me some credibility on the science side of thing. Absolutely. Yeah, but I think a lot of speech pathologists just use that. You interchange them voice therapists. To me, it’s a little more or less colloquial. The pathologist sounds a little more credible sometimes, I guess. So

Dr Marisa Lee Naismith  17:17

it sounds a little bit more qualified, more formal, more important. And we’ve made and yeah, we want to be all those things. Right. Right.

Lori Sonnenberg  17:28

And my favourite, my favourite, you know, title to use in his clinical voice specialist. I feel like that is probably the best representation of what I do in my day is yes. So

Dr Marisa Lee Naismith  17:42

in your work as a clinical voice specialist, what are the most common voice pathologies? Or do you call them disorders pathologies versus disorders? Or is that another range of I

Lori Sonnenberg  17:57

don’t use the word pathology to me refers very specifically to a lesion on

Dr Marisa Lee Naismith  18:03

the vocal hold. All right. Okay.

Lori Sonnenberg  18:07

Right. So, so I probably say disorders, okay, or, or injury more often, but I like disorders, because I feel like disorders is a little more a correct sort of categorical description, right to types of things, because so much of my practice is devoted to what we call functional voice disorders. Because muscle tension dysphonia falls in that functional realm. Yes, yeah. And so, so muscle tension dysphonia with or with our pathology is, is the number one diagnosis in my clinic.

Dr Marisa Lee Naismith  18:47

Really? Well, we I was going to ask you about that a little later. So, but I’m happy to go with you here. So muscle tension dysphonia, that is really common, and it’s more common than what people realise. And it’s actually something that I’ve suffered from myself in the past. And it came at a time when I was completing my PhD. I was working five days a week, as well as doing completing my PhD on a full time basis. So I had no life. I was absolutely just running on adrenaline the whole time. And I was tight as in every part of my body, and I was diagnosed with muscle tension dysphonia. Now, do you want to explain what that is?

Lori Sonnenberg  19:41

Sure. Well, muscle tension dysphonia I I mean, one of the things I want to make sure I say first is that it is a bit of a it’s a bit of a wastebasket term. Oh time. And no, no, no, no. Just seeing like, a lot of things go in the bin. And here and here’s what I mean by that. Because when we means that it’s a big umbrella term rubber, when a doctor doesn’t see anything wrong from an organic or physical standpoint with a larynx, which is what we want, right? We don’t want to see anything. Yes. Even if they don’t really see muscle tension, it’s it’s kind of hard to see that. They’ll that’s what we diagnosed the person with. And the voice is a little, you know, something’s not working correctly or well, about the function. Yeah. And so it encompasses so many things. It can be primary or secondary. That basically the way I like to describe it to my patients and my students is that there are very particular muscles intrinsically in the larynx that are responsible for vocal fold vibration, and closure, abduction and that process, and we don’t really want the extrinsic muscles and operators involved a hole, right? I understand. And so what happens in muscle tension dysphonia usually is that there are muscles that are not supposed to be involved in that process become involved, we start recruiting help from them. With compensatory strategies. Yes. And then, you know, the body learns what it learns.

Dr Marisa Lee Naismith  21:22

And it becomes habitual.

Lori Sonnenberg  21:24

That’s right, the brain learns it. And we’re looking and especially singers like we’re looking at, we’re from the moment something doesn’t sound right or feel right, we start looking for a way around it. Yes, yes.

Dr Marisa Lee Naismith  21:36

I call that manipulating, we start to manipulate. And that’s why often, like when it comes to my singing students, I can tell more so in their speaking voice, if there’s a disorder, rather than their singing voice, because in their singing, we all when we see we can learn to mask it and as you said, work around it. But it’s very hard to disguise in the speaking voice. Yeah,

Lori Sonnenberg  22:03

you’re right. Well, because we’re not as aware of technique. Usually, you know, one of my mentor talks about like, how, as singers, we were really good at dressing up our voices. Like we put all the layers on we put our most beautiful gowns on and our and our coats and our hats and our scarves and we dress it up. And and we’re good at that. Yes, we’re really good at that is. So it can be it can develop all by itself as the primary issue, but a lot of times muscle tension dysphonia is a secondary diagnosis to another diagnosis.

Dr Marisa Lee Naismith  22:42

Really, I guess there’s so many questions here. One, what causes muscle tension dysphonia? So what are those primary and secondary problems that are going on?

Lori Sonnenberg  22:54

So the most common example is, well, there are two I can think of one is is like nodules, or polyps, but especially nodules, very common for singers to develop the muscle tension patterns while continuing to sing and speak with injury present.

Dr Marisa Lee Naismith  23:13

Okay, so that’s pretty serious, right?

Lori Sonnenberg  23:17

And then there’s a lot of Muddy Waters sometimes in treatment, because I have to sort of suss out what’s the main issue here is this Are we dealing with an issue, because of overuse is this person truly overusing their instrument, and that’s why they can’t get better, or is muscle tension, the primary issue, and I were paired with a group of laryngologist, here in the Chicago area, who are super super savvy at diagnosing muscle tension dysphonia in the singing voice, and that’s why so much of my practice involves that usually what we see on an exam just to be really clear here, we usually see a gap of some sort between the vocal folds where they do not come all the way together from front to back, really.

Dr Marisa Lee Naismith  24:04

And that was what I was going to ask you is when just say I’m a brand new patient, or client, and I come to you I’ve never been to before, what is the diagnostic process that one goes through? Typically,

Lori Sonnenberg  24:22

when I evaluate a patient, the majority of them have already seen a laryngologist and a diagnosis has been confirmed. Right? So I begin there are really three major components to my my time with them, and that initial visit one is a very detailed dive into their history. We’re going to talk first Yes, I’m gonna learn everything I can learn about that person. And their their personal life, their professional life, the role that voice plays in their lives, what’s going well, what’s not going well. What is your voice, not do that you need it and want it to do right for you? Yeah, no. And so the history is first and that sometimes that’s not a big deal. And sometimes that’s a really long, deep deep dive into a lot of medical things. The second piece is the actual vocal assessment or assessment of what I call vocal capabilities that I’m trying to find out what is this voice capable of? And then what are its limitations?

Dr Marisa Lee Naismith  25:26

Right. So how do you do that? Is that through like a spectrograph or a scone? Not,

Lori Sonnenberg  25:31

not right now, when I was me, I’m primarily still virtual and teletherapy. Right now, though, the majority I started did away with a lot of my more formal assessment things online. I’ve also been doing this a really long time, and I’m, I’m pretty good at just assessing things with my ears and the keyboard. So I do we do speaking samples, I try to find out like what what can this voice do all the things that it should be able to do? Yes. And in the speaking way, mean meaning louds and softs and highs and lows and authoritative and then we do a lot of sustained sound making so long sounds holding things out. I try to assess the way the breath is working. Are there limitations in the breath? I’m listening to tone and coming up with how do I describe this tone? Is this a clear tone? Is it is it horse? Is it husky? Is it breathy? Is it Are they straining? Are they working too hard? And then singers? If it’s a singer, which it is, yes, we go into more more subtle nuances to Kotti. I want to know what can what can they do with staccato legato lines and transitioning between vowels and and what is the range? Like is this? Is this a balanced vocal range? From a registration head standpoint? Are there a lot of imbalance?

Dr Marisa Lee Naismith  26:59

That’s amazing. And what causes muscle tension dysphonia usually, well what is the most common cause that that you see in your practice?

Lori Sonnenberg  27:12

Usually, the voice either there’s there’s an overuse component, or that is either one time or repetitive, where they’re never quite recovering to their baseline and then they fall into those compensatory strategies show. I call it just kind of getting off track. There’s also lack of use. So you know, the disuse or too much, too much vocal rest. That happens a lot. People are scared. They rest too much for too long. Uh huh. And then they try to come back to singing and then it’s not working like it’s supposed to you.

Dr Marisa Lee Naismith  27:57

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Lori Sonnenberg  30:10

another circumstances getting sick getting

Dr Marisa Lee Naismith  30:15

and people what perhaps returning to work a little too soon and not flavour recovering,

Lori Sonnenberg  30:21

right or the body, the physical body comes back to normal, but the voice never quite comes all the way back. There’s just something a little. And the thing is though singers like I said, we’re really good at making things work. So I think a lot of singers that just bandaid things for a little while. Yeah, and in the muscle tension grows. The other thing I just want to make sure I mention because this you had asked about the primary versus secondary, another very common sometimes under diagnosed issue that where muscle tension can be secondary to it is vocal hold courageousness Oh, okay. Which is which is a weakness in the nerve. Right? Okay, then the nerves and so there’s weakness, there’s sometimes the vocal folds get kind of poppy or one’s not vibrating and moving the way it’s supposed to. And that’s very common in the singing voice to

Dr Marisa Lee Naismith  31:20

Okay, so how do you treat muscle tension dysphonia? I know when I was diagnosed, I was given like accent breathwork. To do, I was given strong foundation, puffy cheeks, that kind of thing. But working on breath, and I know at the time, because I was so highly strong that I was holding my breath

Lori Sonnenberg  31:44

a lot. Yes, yeah, the breath holding is very common with muscle tension dysphonia.

Dr Marisa Lee Naismith  31:50

Yes. And that came from tension. And also the back of my neck was really locked. So I was given a lot of exercises to loosen the back of my neck. Yes,

Lori Sonnenberg  32:01

yes. You know, every person’s priority list is a little bit different. Of course, I am a little out of the box, as a speech pathologist in the way that I that I treat voice, I don’t follow like the typical methods, I sort of create little blends of my own things based on what I think is going to work. And I really rely on my skills of the singing teacher. And therapy, I rely on those skills so much. Yes. And, and so usually there’s, I refer to it as kind of an unloading process. Yeah. So we begin with, let’s make sure the breath is a lot. We’re going to move, we’re going to work with flow, we call it flow phone, we flow the breath. Yes, usually, there’s a component of like laryngeal massage, and I do something called trigger point therapy, where we’re sort of isolating specific areas and applying pressure. And in trying to figure out, what does that do, does that change what’s happening? So then we begin with unloading, but I’m really particular in my process, because even while we’re unloading, I’m being very sneaky. About getting other things going without the person knowing. Yeah, that’s what I’m doing. Yeah. So. So while we’re unloading, I’m already choosing downs for their therapy exercises, where I can tell that they’re getting really clean, clear, adduction, and better vocal hold positioning, really efficient voice thing. So really, I just use my ears in a trial and error sort of way to determine what results in really, really efficient voicing for this person. Yes. And then that’s all we do for a little while. Okay, so

Dr Marisa Lee Naismith  33:56

it’s just repetitive work to begin with

Lori Sonnenberg  33:58

very repetitive. We start with very short, frequent practice, and, and we get results, usually, I mean, very quickly, usually, the person is feeling better when we finished the first session, and they go away, and they do it. And as the voice becomes more efficient, and we’re unloading and peeling back the layers of tension, and so forth, and we get in there and we start building, and we’re going to build and we’re going to start to work on resonance and aural shaping and vocal tract shaping. And then we move into vowels and tongue positioning. And I mean, it’s just a lot of different things.

Dr Marisa Lee Naismith  34:39

It’s like a massive can of worms. It is, it’s a lot, isn’t it. That’s it. It’s incredible. I just want to move on to now there was when we had a meeting some weeks ago, you talked about vocal folds swelling as well. That is something that is very, very common and many Voice users who, like professional voice users don’t realise that they have it. So do you want to talk a little bit about what that’s all about? Yeah, so

Lori Sonnenberg  35:11

I’m gonna talk about, oh, well, I have learned that this kind of comes from my knowledge about swelling and how it comes and goes in the life of a singer or a professional voice user comes from taking people through that process of resolving swelling and injury and helping them learn the day to day, week to week balance of how much voice and how much silent, right? balance can be. And so vocal folds swelling, I mean, really swelling is our body’s way of trying to protect us. So we, you know, vocal vocal fold vibration is a biological thing, it is not infinite there. And so there is a limit. Yes, there is we all have a limit, your limit and my limit are different. And, and so the thing about fouling and vocal fold vibration, you know, did you know that there is no other tissue in the human body that gets subjected to the kind of trauma that vocal folds do on a daily basis?

Dr Marisa Lee Naismith  36:19

I’m not surprised because we’re constantly using the vocal folds not only to find aid, but they have other little jobs that they do as well. So yes,

Lori Sonnenberg  36:29

yes. So so we vibrate so much. And if we go past the limit, the vocal folds are going to there are going to be these little cushions that kind of pop up, you know, on the vibrating edge of the fold to protect us. But when that little cushion pops up, something’s going to change about the voice. And we have to know what the in our body or our voices are gonna give us a warning signal that that spelling is present. Now, if you’re not a singer, you might not know. Yeah,

Dr Marisa Lee Naismith  37:02

so what are the warnings? And I didn’t ask what the warning signs are of muscle tension dysphonia either. So how can we tell that we have something sinister going on? Or potentially sinister?

Lori Sonnenberg  37:16

There are some really key common signals, warning signals, I like to call them for singers especially and I, you know, I ever I do work with non singers, but just for the purpose of our conversation, I’m Yes. Going to use that. So And remember, the outer edge of the vocal fold is the mucosa. So we are referring to mucosal swelling in this Yes, yes. So the number one thing is loss of a high soft thing. Ah, that’s interesting.

Dr Marisa Lee Naismith  37:49

Because even in I mean, how many students come to me and they say, I can’t sing high, softly. The only way I can sing high is if I sing loudly.

Lori Sonnenberg  38:01

Yeah. So you know, we don’t know. We never know unless we look right. So but it’s, it’s one thing for someone to say I’ve never been able to do those notes that way. But it’s another thing for someone to say, I can’t sing about G five today. Like I’ve lost everything above that, what what’s going on? Okay, so, but loss of high soft thing, because even the smallest of vocal folds swelling might not interfere until soft head voice or soft falsetto. And you have to get quiet to notice that. So the loss of high soft singing day to day variability. Uh

Dr Marisa Lee Naismith  38:41

huh. So the voice behaving itself one way on one day, and the next day, the voice behaves differently. So the voice is inconsistent from day to day. And you exactly and you don’t know how it’s going to behave. It’s just random, right?

Lori Sonnenberg  38:59

But there’s almost always a pattern in there. And that’s one of the fun things is helping people find those patterns. So the other really common things are onset delays. Mm hmm. air escape in the tone, yes. And increased effort. Right. Okay. So those are probably the top five warning signals that come out. Another thing that kind of stands out just for like our listening audience, so colds and viruses and upper respiratory type things, even allergies, and reflux and all these things that that can really cause havoc, and they’re, they do cause they cause what we refer to as more global swelling in the environment. So the whole area is going to be inflamed and you’re

Dr Marisa Lee Naismith  39:44

right, right, but not just the folds, right, vocal

Lori Sonnenberg  39:48

folds swelling is vocal. So if someone happens to have a little baseline swelling, that other swelling on top Half of it is going to really just make that voice very impaired. Okay,

Dr Marisa Lee Naismith  40:05

so it’s going to wreak havoc.

Lori Sonnenberg  40:07

Right? Right. So now vocal folds swelling? Well, I get very excited about this topic, people get stressed out about it, because it’s a scary thing sometimes. But the reality is when we are a busy bulk, when we are a busy vocalist, we have very high expectations of our voices on a daily basis. Absolutely, yes. And we’ll listen to the warning signals a lot of times and and we say, well, I got to teach that lesson. And I’ve got to sing that rehearsal. And, and so when you go when you ignore the signal, even if it’s the smallest little signal, but then that signal, keep showing up, then you’re moving towards something a little more chronic. So regular monitoring, knowing how to monitor mucosal swelling is important. Now, one of the things that’s confusing is the difference between, okay, I didn’t say vocal fatigue, and I should have said vocal fatigue, because that should be in the list of common complaints. Yes, vocal fatigue could mean so many different things. How do we know what it means? And so I talk a lot with my singers about the difference between is what I’m experiencing mucosal welling issue from overuse for board isn’t really a muscular thing. Wow. Okay. How do we know the difference?

Dr Marisa Lee Naismith  41:33

Well, that’s something you can diagnose, obviously, well,

Lori Sonnenberg  41:37

we have to assess it out. You know, we talk about Okay, tell me exactly, you know, we talk about the exact thing. So, what I have learned. Now, this is all anecdotal, you know, there’s no paper out there. But this is based on close to 18 years of clinical experience here. And what I have learned is that it takes a characteristic of vocal swelling is that it usually takes a little while for that to show up in the voice, right? Like, you’re not going to notice swelling, like immediately, it’s going to be like a few hours later, or sometimes the next morning, is when filing shows up.

Dr Marisa Lee Naismith  42:14

So one thing you mentioned to me when we were chatting some weeks ago, was that with vocal folds swelling, usually people when they wake up in the morning, that it takes their voices some time to warm up. Was that correct? Well,

Lori Sonnenberg  42:31

it depends. It depends. If you don’t have any swelling, you should be, you know, ready to go pretty quickly. What I may what I’m you may be referring to is that, okay, so if you want to try to find out, am I swollen today? How do I know you can just test your Hi soft voice

Dr Marisa Lee Naismith  43:00

there’s a little break in there. That’s

Lori Sonnenberg  43:04

so so but I know in my voice, you know, and you you go into falsetto, or your very high head voice, you get really soft. Like you just want to be able to be

Lori Sonnenberg  43:22

Yeah, that’s how you do a spelling test. So if I were still one, this is what I’m gonna sound like. Ah, you know, there are times

Dr Marisa Lee Naismith  43:32

I do sound like that. We all do. Yeah, a bit, especially after a really long teaching day. You know, some days, I may teach for 12 hours without a break. I mean, the next morning, I may be a bit tired, or if I’ve been out and being in a noisy restaurant, yes. And having to have big conversations with a group of people. That is another time that happens in the morning. That’s probably my worst is being out in a noisy environment.

Lori Sonnenberg  44:06

Yes, but see, we all do that. And then we the next day, we might we’ll be warming up and we like, like, those notes are sometimes kind of weird up there. You know, they’re not working as well as they usually do. And but we just bump up you know, whatever. It’s fine. I’m probably just a little tired. But yeah, are you really tired? Or are you swollen? Yes. And so now the muscular so just to kind of finish that thought. So, swelling usually takes a little while to show up, but it also takes a little longer to go away. All right. So so when we want you to recover overnight, that’s what we want. No more than one to two days, muscular issues. So if you start to feel fatigued and or even getting a little hoarse, muscular, almost shows up immediately like that I tap in like right away,

Dr Marisa Lee Naismith  44:55

right. I had something that was going on with my voice Many, many years ago was the only time I had some sort of disorder going on. And I was touring in a rock band. And, you know, I’ve had a big career already, my voice at all always behaved itself never had any vocal issues. And with this rock band, I blamed the lifestyle, because there were a lot of things going on a lot of heavy lifting, lugging gear, very late nights, not sleeping properly, lifestyle, eating bad food, the position of the monitors on stage where I couldn’t hear myself and trying to sing loudly to be able to get some sort of feed, like oral feedback, and also the demands from management that we’d have media on the days off, and all those sorts of things. And it started off that very slowly. That one day, you know, my voice started to become a little shady. And to the point where I after not even finishing one song, my voice just cut out. Yeah. And that’s when I knew I was in deep trouble. But I knew there was something going on earlier, and I was doing my best to try and keep going. Because in the industry, it’s all about the show must go on. But how many people come to you, when it’s too late? Like, they don’t listen to the warning signs. They know something is up, but because if we don’t work, we don’t get paid. We keep pushing through. Do you see that a lot? Yeah,

Lori Sonnenberg  46:39

absolutely. And, you know, I don’t ever feel like it’s too late. I really don’t. I don’t I’ve had too many successful experiences with singers, bringing them through the injury experience and journey and recovery, whether that involves a surgery or not. Sometimes it does, sometimes surgery is exactly what that person needs to get them back to original equipment or as close as we can get them to original equipment. Yeah, and if you’ve got a great surgeon, there are rarely issues with that. And so, and I love that I love helping singers recover from surgery. It’s a really fun process. But a lot of people a lot of the people that that I see with official vocal folds injury now not just not the technical aspects or functional aspects of muscle tension dysphonia, I talk about those a little separately. You know, I don’t call muscle tension dysphonia and injury thrive. And, and but most of them have like pushed, you know, push the voice past that limit. So many times not really understanding what was really happening in there.

Dr Marisa Lee Naismith  47:53

Yes. What are the worst injuries one can have as a singer? What would be your worst nightmare?

Lori Sonnenberg  48:00

Oh, gosh,

Dr Marisa Lee Naismith  48:01

would you say what? What would you not want to have?

Lori Sonnenberg  48:06

I wouldn’t want to have an injury that was under the surface of the vocal hold. So usually vocal folds cyst, or under the surface thrives. And so but I’m going to take that one step further. If so, if you if you continue to work on an injury, that’s very obvious, and if it were a cyst under the surface, it can burst. And there and long term damage can cause a little something that we refer to as a sulcus. So that means there’s like a little divot in the mucosa. There’s like an actual little furrow. Yes.

Dr Marisa Lee Naismith  48:49

Wow. Okay.

Lori Sonnenberg  48:50

And it turned, you know, it’s scar like, it’s got scar tissue, and it can be dealt with surgically. But it’s a really, really difficult thing to get improvement in. And most other apt, but I have, I’ve helped one of my favourite post op cases, or preoperative and post operative in my memory, was a young singer, a college student who had two cysts, one on each side. Wow. And so when we’re dealing with something like that, because you can’t operate on both sides at once, you have to do them separately. So you have to do the first surgery, and then it’s like months of recovery. And then we do the second one, and then it’s another stretch of recovery, and it took a good year to get that singer back on stage. But it was such a rewarding, joyful thing when it was all over.

Dr Marisa Lee Naismith  49:46

Are you ready to scale and share your products or services globally? Well, introducing a voice and beyond the podcast that reaches listeners in 99 countries. Is across 2185 cities, ranked in the top point 5% of podcasts globally, a voice and beyond is offering you an exclusive opportunity to connect with an international audience. This isn’t just about advertising. It’s an exclusive and unique chance for businesses and individuals to amplify their message worldwide. So whether you’re a member of the voice community, a health care professional, an author, a budding entrepreneur, or an established brand, seize the moment to be heard where it matters most, you can email me on info at Dr. Marisa Lee naismith.com, or visit the link in the show notes to learn more about this extraordinary opportunity. Whatever you do, don’t miss out on reaching our global audience. Because your voice deserves to be heard everywhere. So would that be the worst case that you’ve seen?

Lori Sonnenberg  51:17

I don’t know. I don’t really read them like worse than well, has

Dr Marisa Lee Naismith  51:21

someone come to you and you’ve just gone? Well, this singer has some serious problems going on? Houston, we have a problem. The problem?

Lori Sonnenberg  51:32

I think, I think the most the worst situations like that are when the vocal hold tissues are just so beat up from a lifetime of of asking more than they should have. And it’s in part, it is possible to continue to sing pretty well. I mean, there are some pretty high profile singers with vocal cord injury that probably have very little vibrating, viable tissue left. And they’re, they’re singing, they’re still making money and doing a good job. So do

Dr Marisa Lee Naismith  52:07

you listen to those singers and go, Oh my gosh, I just can’t listen to that. Knowing that they aged.

Lori Sonnenberg  52:14

I don’t really I’m very versatile in my listening. I’m appreciative and enjoy a lot of different singing styles. I grew up listening to pretty intense, a heavy metal and rock rock. And I don’t react that way. I mean, I I’m appreciative of even those really aggressive sounds that that we can make vocally because I always say, you know, our voices were designed to do this stuff for us. Yes. Yeah. I mean, really, they were made to, but it for me, it’s when people just continue to push past without that awareness. And that makes me think of how hard it is for singers to go for help to ask for help. You know, I It’s a mystery to me. Yes, it’s such a mystery. It’s why why would you not go get answers? That is all about the

Dr Marisa Lee Naismith  53:07

shaming. There is still shame around having injuries and disorders. I mean, look at poor Adele, when she had her last lot of vocal injuries. I was totally embarrassed to be a voice teacher. I was ashamed as a voice teacher to read some of the commentary on social media forums, from our professional voice teaching community. I mean, I can see why they don’t go and have help ask for help. If it was shameful, it was shameful what I was reading. And people seem to have all the answers and they don’t know.

Lori Sonnenberg  53:50

And yes, we features we do we we lot. We feel very knowledgeable.

Dr Marisa Lee Naismith  53:55

And very opinionated, and very few. Unless you’ve walked the walk and you talk the talk. You don’t know what’s going on in a person’s life. Now, for example, I had vocal injuries as are a disorder, whatever it was at the time, but that lifestyle was not helping. And you don’t know now Adele had done something like 100 shows. It was her last show. She’d been on a flight every second day. Come on people. You know it is

Lori Sonnenberg  54:30

it is brutal. It is a brutal, brutal lifestyle and what I want and I always chime in when I feel when I get my feathers, you know a little ruffled. i Why am I here I come. Yes. And I say my my pushback is okay people this is not she didn’t do anything wrong. No. You know, she’s seen it. Do you know how many shows she’s singing every week? Yes. The voice was not it was designed to do Amazing things. But remember, I said it isn’t infinite.

Dr Marisa Lee Naismith  55:04

Yes. And also to what I mean, it was a lot of the classical voice community that was chiming in on all of those forums. And they only have to sing a few songs. And then they go home. I mean, when I was singing professionally, there was a time when I was a single parent, and I had to put food on the table for my daughter. And I was taking every job possible. And there was a stage that I was working 11 gigs a week, the minimum, the minimum I was doing was a three hour call. And then, so I was working from seven to 10, and then going to a nightclub that was seven nights a week doing that, and then four nights a week, I would go into a nightclub and sing from 1030 till three. Now, that’s not getting up, and just standing there, sorry, classical singers, but we have to move. We have to have banter with the crowd, we have to speak to people in between, we ask voices don’t get a break from the time we arrive to the time we finish. So I really different

Lori Sonnenberg  56:24

and, and, you know, the the thing that I, I dream, I dream of a world of a voice world where we all understood those nuances of swelling. And and I dream of a world in academia and in private studios and in theatre in the theatrical world. And in the commercial singing world, where everyone gets education in that.

Dr Marisa Lee Naismith  56:52

What is it?

Lori Sonnenberg  56:53

How do I know if I’ve done too much? And what does that really mean when I feel like that? Yes, yes. If everybody knew that, and knew how to test for it, we could we could cut some of these things off at the past, you know, and, and I, and that’s how I work with my patients. I don’t let them I say, No, we’re going to monitor this. And we’re going to test it every single day. And you’re going to write down what that is. And you know what, it empowers them to make really good choices.

Dr Marisa Lee Naismith  57:27

That’s fantastic. Okay, I’m going to ask a very controversial question here. And Laurie, I would really appreciate an honest answer. So we’re not going to we’re not going to fast. That’s what I Australian term, we’re not going to refer for a particular community that exists within our great waste teaching community. So when it comes to injuries and disorders, are CCM singers, more likely? Or do you see a higher incidence of problems within that group of singers than classical voice singers?

Lori Sonnenberg  58:12

That is a great question. And not one that I think about a whole lot. Oh,

Dr Marisa Lee Naismith  58:16

that’s good. So you don’t have biases? You

Lori Sonnenberg  58:20

know, I really don’t think I do yeh.

Dr Marisa Lee Naismith  58:25

From the classical world, I’m very proud of you know,

Lori Sonnenberg  58:28

I don’t I see all genres equally, and my practice and styles and environments, and the only thing I would say is that, then this is from the muscle tension dysphonia side of things, because when I mentioned that issue with a gap between the vocal folds, yes, and usually the gap is towards the back of the so if you’re looking at vocal folds on a screen, and then there’s going to be more of a gap in the back here. I do tend to see that shape of the gap in Belters that take chest voice a little too high. That’s the only thing I can think of, but that’s not necessarily like an injury type thing. It’s more of a technical thing that okay, that gets imbalanced and so we just have to teach them how to rebalance that. But But no, as far as injuries concerned, I mean, everybody walks through the door, they’re coming from all different. I mean, I’ve i i see impersonators. You know that from from Elvis impersonators to the upper echelon elite, classical soprano at, you know, the Opera House. I mean, and everything in between. Yes.

Dr Marisa Lee Naismith  59:43

So what you were talking about, sorry about that. Beltre. That’s, that’s obviously a training issue. They haven’t been trained correctly, to belt that high. And I love that you’ve said that people come to from all walks of life. If they sing across a variety of genres, no one is more problematic than others. And because to me, this would be my assumption. And it’s not based on anything other than the sheer workload that these singers have to, you know, their workload, not only in terms of singing, but they have to speak as well, is musical theatre singers, I worry about them, because of all the different styles that they have to be able to sing across. It’s basically nonstop for a lot of them for two hours on stage, everything else the positions that they have to sing in, I would assume that they would, could possibly end up in trouble, more so than singers that other singers from,

Lori Sonnenberg  1:00:47

from my perspective, part of the problem with that a big part of the problem is they get confusing messages in terms of vocal health, like the the value of their vocal health and the priority of, you know, their vocal health in the rehearsal situations and the way programmes are put together course curriculum, the training, the way it’s all built, because we don’t, we want you to be careful, and we don’t want you to injure yourself. And we support you, and we care about that. But we’re gonna run the show twice today. Yes. Okay, so where’s the logic in that? I mean, there’s no way there’s no way, especially young singers, there’s no way that they can handle that kind of load. And see that’s confusing to them, because then they feel like this is being presented as I’m supposed to be able to

Dr Marisa Lee Naismith  1:01:45

do this. Yes. And to thank them when they can they feel shameful? Exactly. And do they have a support team in the US for musical theatre singers? So just say if you’re in a production of hairspray, that production show has different therapists that like physiotherapist they have? That’s

Lori Sonnenberg  1:02:09

a great question. I think we’re there’s definitely more of that happening. Like on Broadway, that’s probably one of the few, you know, locations where more of that is happening. But at then regional theatres, local theatre, I mean, even I don’t know, with touring companies? That’s a great question. It’d be a good question. For someone who’s familiar with that? Yes. But at the regional level, local level in the school, you know, people get hired to be vocal directors. And they half the time, a lot of times the vocal director isn’t very familiar with injury and how to protect the students from that. And so then they’re putting forth these expectations. And then they all wonder why when you get to tech week and or two days before the show, nobody has a voice. Hmm,

Dr Marisa Lee Naismith  1:02:54

yes. A lot of the time, people in those leadership roles because I know this, my daughter works on cruise ships. And I know that the writing sample, the vocal captain is not necessarily someone who has the most training, it’s someone who sings, according to the production team, who is the best singer, who might be the most experienced or may have had the greatest career leading up to that contract, but has no knowledge of how the voice works.

Lori Sonnenberg  1:03:27

Right? Well, and see another another thing that’s kind of tricky about vocal folds swelling and injury is that it responds really, really well to warm up. So if you you can cover that up pretty quickly with your warm up, and the voice responds to that and it gives in and so that’s why we want to teach singers to monitor before they warm up so that they have some sense of what that naked voice, right like,

Dr Marisa Lee Naismith  1:03:59

Yes, so what is your favourite warm up or what would your preferred warm up regime be? What would involve?

Lori Sonnenberg  1:04:10

I like to start with something that gets the airflow moving. So either lip trills, tongue trills, raspberries usually when of or or straw foundation in water,

Dr Marisa Lee Naismith  1:04:20

or you prefer in water? Yes,

Lori Sonnenberg  1:04:23

yes. Well to start out with usually. So lots of gliding, just lots and lots and lots of lot of up and down to begin with. I usually want people starting with airflow of some kind moving it then I just like sustaining tones on something that feels really good vibe. voiced consonants are really valuable like movies and am my favourite warmup for muscle tension dysphonia is the L consonant really. Oh,

1:04:58

Oh, oh, okay.

Lori Sonnenberg  1:05:03

Yeah, yeah, I’ve worked with L a lot and therapy.

Dr Marisa Lee Naismith  1:05:06

So what does that do? Why do you like the L so much? Well, the tongue

Lori Sonnenberg  1:05:10

is I mean, we, you notice the tongue is a, it’s a muscular hydrostat. So it’s, you change the shape in one place, and it just distorts and another. So, so when we make that L position with the tongue, it’s sort of in this, you know, it’s in this sort of, diagonal position hole. But the root of the tongue goes to such a position back there, that it aids in vocal fold. adduction and enclosure, usually, and it’s really great for mixed voice. Okay, like, Yeah, and so I love l, my favourite of all time, if you said to me, Laurie, forevermore with all of your students, patient injury, healthy singer, injured singer, or whatever you want to call it, if you could only pick one exercise to carry forward forever and ever and ever. And if it was you could use Yes, it would be the word. No, K, N O L L.

Dr Marisa Lee Naismith  1:06:13

Que no, no.

Lori Sonnenberg  1:06:17

See? No. Really thought. Let me demonstrate. No. Oh, no. Oh, it’s just this perfect little combination of the n the all and not necessarily saying the L but sort of thinking thing else. So

Dr Marisa Lee Naismith  1:06:39

one question on that. When you say the so is it a dip song that you’re using? So is it just no or is it No, like an O E? Is it an or Oh? Oh,

Lori Sonnenberg  1:06:55

more? It’s more Oh, okay. Teach it. It’s more Oh, okay.

Dr Marisa Lee Naismith  1:07:00

Okay, so it’s still that Italian vowel like more, you sitting on the open open part of the first vowel and you stop it there? Yes.

Lori Sonnenberg  1:07:09

Now, Hey, have fun with it. It works really well across genres. And I mean, I just have so much success with it. It sort of comes from a very beloved exercise routine therapy exercise routine that was created in the 90s by someone named Joe Stemple. He was a speech pathologist. He just retired in recent years, but no was sort of came from one of the exercises in this regimen that he called vocal function exercises. And he didn’t really say it was normal, but when you watched and listened to him demonstrate it, that’s what you heard. And so that’s kind of where it came from. And so I’ve been working with that sound in my choirs and solo stuff. I have a lot of success with it. Now, the challenge is that for the CCM singers, it’s not the best vocal shade. I’m sorry, it’s not the best vocal tract shaping a yes. For what they need. And so I use, I use it more therapeutically with them. And then when we need to cross over into more training aspects, we have to abandon that usually and find something

Dr Marisa Lee Naismith  1:08:18

a little bit okay because it’s lowering the vocal tract. Yeah, it’s

Lori Sonnenberg  1:08:23

just too is too long. And yeah,

Dr Marisa Lee Naismith  1:08:27

okay, so what is your favourite call down because singers generally forget to call down or they don’t realise the importance of a cooldown what would you suggest my favourite

Lori Sonnenberg  1:08:39

cooldown there will there to either trough donation o or lip trills it really lip trills. And I, I like downward like descending lines. I teach my singers to do a lot of downward movement with the voice for cooldown.

Dr Marisa Lee Naismith  1:09:00

Okay, because one of the most popular call downs here in Australia is just doing like some vocal fry.

Lori Sonnenberg  1:09:08

I like vocal fry. i Yes, I love it. I teach a have a whole barrage of therapy exercises and singing exercises that come out of what I call creaky voice. Yes. Noises Yeah. And yeah, and no, I love vocal fry. I don’t, I only recommend it for cooldown or relaxation purposes. When I have my muscle tension dysphonia singers, that means something to sort of pull them out of that kind of intense place. But I that’s interesting. That’s very interesting to me. Yes. I like

Dr Marisa Lee Naismith  1:09:47

to bring everything back to neutral and back into specially for high Belters where your larynx has been floating from that neutral, high position. It just happened brings everything more into a neutral position again.

Lori Sonnenberg  1:10:03

I love that and I’ll I’ll buy that

Dr Marisa Lee Naismith  1:10:06

I pay a bill I taught Laurie something I’m so proud. Now we’re down to the last final questions, you’ve been amazing. And I’m just going to ask you, this is for my students, because I’ve had a number of students who have recently had COVID. And they’ve come in with some vocal issues, they’re saying their voices are not behaving, that is actually the words that they’re using. Okay, they’re having some little funky pitch issues going on. So every now and again, the voice cuts in and out. But they can’t rely on their voices to do what the voice was doing prior to COVID. So there’s a little bit of lack of control over the voice for want of a better word, because we don’t like to use the word control. But the voice is not responding perhaps the way that it used to prior to COVID. Is this something that you’ve seen with any of your patients? Yes, sometimes

Lori Sonnenberg  1:11:05

a lot of? It’s interesting. I have a lot of people that don’t disclose that they’ve had COVID. Not not on purpose, they just forget to mention Oh, and by the way, I had COVID, six months ago, you know, and, and I have to kind of dig into it. But yes, I think that I, I would call I like what you’re saying like lack of control? I am, I am seeing some of that I think of it as sort of, I also think of stability.

Dr Marisa Lee Naismith  1:11:33

Yes, as

Lori Sonnenberg  1:11:35

like a grounding in the voice like a grounded stable instrument. And I think a lot of it is like coordination related. And so identifying, so what I’ve been doing is just kind of like my normal process identifying, okay, what I always say, with with singers, we’re going to come down to the smallest denominator, we’re going to find the smallest number of things to think about when we make this down to get better. And, and so finding a sound that really coordinate the breath with vocal bone closure and adduction. And then the resonance, they have to go together. Yes.

Dr Marisa Lee Naismith  1:12:17

And and I think the key this, this would be my theory would be that because COVID really does impact on breathing, the lungs, the breath, that a lot of those issues may be coming from air pressure.

Lori Sonnenberg  1:12:34

I agree with you, I absolutely agree with you. That

Dr Marisa Lee Naismith  1:12:37

was the thing that I noticed when I had COVID Was that it felt like someone was sitting on my chest and my breath was labouring. And I’m thinking that the singers there maybe because they are singers, they would notice it, whereas probably the average person wouldn’t so much.

Lori Sonnenberg  1:12:56

Yeah, I I’ve had a lot of I do a lot of manual therapy and hands on or with, especially with muscle tension, but with breath work as well. And a lot of my singers recovering from COVID, we’ve had some success doing some like hands on work where the identify like areas in the chest or the ribcage or the abdominal area, where they might be able to identify holding of tension. So even sometimes just pulling, you know, putting the hands on the chest and kind of pulling away, you know, to sort of open those Yes. Is that Yeah, yes. And that’s that’s kind of I’ve had some success with that. As simple as it is. It’s amazing how they start to feel some control over the breath with that, and then the voice is going to come out smoother and more coordinated. Yes.

Dr Marisa Lee Naismith  1:13:49

Well, thank you for answering that on behalf of all my students. Okay, so final question. And then by the way, we’re going to share all your links with our listeners. So if people want to learn more about you, we will have all those in the show notes. And if they want to visit your website or make friends with you on social, we will share all that info with them. I love

Lori Sonnenberg  1:14:16

it. I’m new on Instagram of late. Oh,

Dr Marisa Lee Naismith  1:14:21

yes. Well, I’m not a fan of social media, to be honest. And I shouldn’t be saying this because there’s a lot of promotion that goes on around. There’s a podcast on social but I have someone that takes care of that form. It is as

Lori Sonnenberg  1:14:38

I say it is a labour of what I love. So yes,

Dr Marisa Lee Naismith  1:14:42

so what can we piece of advice for our singing voice community? What can we as teachers do better to take care of our students in terms of vocal health?

Lori Sonnenberg  1:14:55

Talk about it with them? I think we need to be having a lot more conversations in all of the spaces that we exist with our singers in the studio and classes in the theatre in Backstage at the concerts. I mean, we need to be talking about asking, how’s your voice doing? Do you ever notice changes in your voice, you know that that’s that monitoring piece, but, but if we talk about it with them openly share our own experiences of limitations or problems that we’ve had, it opens the door for them to they recognise, I think this is a person that I can talk to about this. And I don’t have to be fearful of bringing this up in conversation.

Dr Marisa Lee Naismith  1:15:47

That’s great advice. And that really goes along with what I try and advocate through the show. And that is holding safe spaces for our students to be heard. It’s not about us, we need to leave our biases at the door, but listen to what our students are telling us.

Lori Sonnenberg  1:16:08

That’s right. That’s right, and not wipe it away with a word like, well, your voice is just tired today.

Dr Marisa Lee Naismith  1:16:17

No, no, that doesn’t have it. No,

Lori Sonnenberg  1:16:20

no, it really doesn’t. And, and also not swipe it away with Well, if you just do this differently, I bet it’ll come out. Okay. Yes,

Dr Marisa Lee Naismith  1:16:29

that’s where we must learn to have conversations with our students and find out what’s really going on.

Lori Sonnenberg  1:16:36

Don’t wait exactly right. Because they I can tell you from my side of things, being the professional that supporting them in that recovery journey, that they need, and want that so desperately, they’re so afraid to tell you what’s going on.

Dr Marisa Lee Naismith  1:16:54

They are unless you build that trust within the studio, and we have a responsibility as voice teachers to take care of our students, and to make sure that they’re vocally safe. And we do the only way that we can do that is to allow them to communicate with us what they actually need, and to listen to them. Yeah, well, Laurie, it’s been amazing. I’ve loved listening to everything that you’ve had to share with us. You’ve been really generous with your time with. It’s been a long interview, but I just wanted to keep knowing more. And the listeners are going to learn so much from you. Thank you for your time. And good luck, and I’m sure we’re going to catch up sometime soon. I must come back to Chicago. It was oh, I hope

Lori Sonnenberg  1:17:43

you will I love I would love to host you here well, all the time.

Dr Marisa Lee Naismith  1:17:49

I know we will. Okay, thank you so much. Take care.

Lori Sonnenberg  1:17:55

Thank you, Marisa. Bye bye.

Dr Marisa Lee Naismith  1:17:59

Thank you so much for listening to this episode of a voice and beyond. I hope you enjoyed it as now is an important time for you to invest in your own self care, personal growth and education. Use every day as an opportunity to learn and to grow, so you can show up feeling empowered and ready to live your best life. If you know someone who will also be inspired by this episode, please be sure to copy and paste the link and share it with them. Or share it on social media and use the hashtag a voice and beyond. I promise you I am committed to bringing you more inspiration and conversations just like this one every week. And if you would like to help me please rate and review this podcast and cheer me on by clicking the subscribe button on Apple podcast right now. I would also love to know what it is that you most enjoyed about this episode and what was your biggest takeaway? Please take care and I look forward to your company next time on the next episode of a voice and beyond.