Can a calm, patient and reassuring tone of voice have a positive impact on psychiatric patients' behaviour? While there hasn't been any substantial research conducted to prove this theory in Thailand, local medical experts say the voice is a powerful therapeutic tool if the conditions are right.
Judging from the experience of retired nurse Sunee Ekwattanapan, who worked with psychiatric patients at Srithanya Hospital for 30 years, the voice of popular radio host Rassamee Maneenil is a case in point. Back when Sunee headed the nurse station in the late 1990s, Rassamee's story-telling radio programme not only helped relax the nurses who were listening in, but amazingly a group of patients as well.
The format of the show was simple, the host read aloud excerpts from popular books while accompanied by soft background music. After listening to Rassamee's programmes a couple of times, the nurse was hooked. She found her voice mesmerising and calming. And Sunee came up with an idea.
"At the time, we were conducting research work to determine which alternative methods could be used to help our psychiatric patients relax. We had already put them on a macrobiotic diet, and had tried a string of relaxation techniques to make them unwind. Some, such as the dhamma sessions, helped, but not with significant results.
"I just felt that if Rassamee could have a positive effect on my emotions, her show could probably benefit these patients. After she gave me permission to use her programme as part of the counselling session, I was pleasantly surprised to observe that the first reaction from the group was rather promising, they demonstrated an eagerness to listen to her. In a duration of three months, I found that we were able to reduce their sleeping medication to half the amount.
"They also slept better and were less boisterous. I went on to use her radio programme for a year. Of course, it was a combination of medication and counselling that also played a vital role in their recovery, but we cannot rule out the fact that the radio programme helped them to calm down in leaps and bounds."
Sunee says an anxious tone of voice can be as damaging to a patient, as a relaxed and mellow voice is healing. Having worked with psychiatric patients for most of her career, Sunee says people in the medical profession should take extra precautions while speaking with patients as an agitated voice often triggers a negative reaction.
Before attending to the sick, she cautions nurses and doctors to leave their emotional baggage at home.
Telephone counselling, in particular, requires confidants who realise the importance of lowering the pitch of their voice and staying calm with the caller to successfully address their emotional needs, Sunee said.
"Thai society is increasingly becoming more self-centred and less caring towards the feelings of family members and friends. I believe that if we don't want to have our loved ones suffer silently from the way we talk with them, we need to stop and think and determine if the tone of our voice is hurtful to others. We should ask ourselves if there is something bothering us to the point that it comes out in our voices. As a society, we have to learn to become less anxious."
Achara Bunnag, a senior psychotherapist at Manarom Hospital, couldn't agree more on how the tone of voice, intonation and pitch all work hand in glove to calm a person's agitated state. Commenting on how an untrained voice could have a profound effect on people with psychiatric problems, she said: "For such individuals, a lot depends on how ready they are to give up personal control over the situation they have been put in. In this case, the first thing is that they are listening to the radio programme because they desire to do so. On the subconscious level, they are involuntarily opening themselves to letting a radio host's voice guide them to feel relaxed.
"In the subconscious, two things are most likely taking place. Apart from finding her programme interesting, it is also highly possible that they find her voice comforting.
"To be able to have a composed voice, I am pretty confident the radio host rids her mind of all worries before coming on air."
For Achara, the importance of the voice is especially evident during relaxation treatment, which is often used in cognitive behavioural therapy (CBT), a technique used to help people understand the thoughts and feelings that lead to potentially problematic behaviours. Relaxation therapy is not limited to CBT, and psychotherapists can use it as they see fit, she said.
During treatment, Achara's patients are coached to perform breathing and relaxation exercises and to focus their attention on a pleasant situation. She says the proper use of the voice, especially during the the guided imagery phase of the treatment, is essential.
"Guided imagery is a system of visualisation that can be used to help in relaxation. In guided imagery, you are led to imagine all of the details of a particular situation where you are safe," she said.
"Clients can feel if the person administrating the treatment is anxious themselves from the tone of his or her voice, so you can't really pretend. I am a naturally relaxed person, so it probably comes easier to me when I conduct these sessions.
"As the point of the exercise is to help them relax, my voice has to show the least amount of stress possible to make it work. Once the clients learn to lead themselves through the guided imagery, they will be able to invoke their secure spot at will, even in the middle of confronting their phobia."
Patients often ask Achara to record her voice while she takes them through the guided imagery exercise so they can use it during an emotional crisis.
"A point of interest is that most of them don't want their parents to be the ones to record their voices for them to listen to because they feel the tone to be demanding and disciplinarian at times," she explained.
"As relaxation therapy is a tool for stress release, the appropriate use of the voice can make all the difference in the success of the treatment."
Rassamee, who has never received voice training, noted that her voice seems to put her listeners in a chilled out mode. She finds this rather baffling because all she does before going on air is meditate for a couple of minutes to clear her mind of anxious thoughts.
"Some of my listeners have told me they sleep better after my show, while others say it helps them to clear their mind after a stressful day. A handful of monks have also requested if they could use my programme as part of their dhamma class. I feel good about being able to touch the lives of radio listeners in the last two decades of hosting shows relating to social and family issues. I don't understand the dynamics that go into how a person's voice can influence another to feel in a certain way, what I know is that I am being genuine."
About the author
- Writer: Yvonne Bohwongprasert