This disorder exists when there is psychological trauma or conflict that is manifested physically. In the case of conversion dysphonia or aphonia (complete loss of voice), there may be a single traumatic event such as an accident, death, or psychologically damaging event, and there is change of voice within a short time. Or, there may be a long term psychologically damaging circumstance, such as sexual abuse, that may be manifested soon or many years later. In the case of conversion disorder, the individual may undergo functional voice therapy to gain control over his or her voice, but in most cases the voice disorder will not resolve unless there is also psychotherapy to address the underlying problem.
Juvenile Voice/Mutational Falsetto/Puberphonia
This disorder exists when there is some psychological reason for an individual to resist the maturing and lowering pitch of the adult voice, and maintains the higher pitch of a preadolescent. This disorder is much more common in adolescent males, but can also exist in females. The voice therapist may be able to elicit a normally low-pitched voice by engaging the individual in certain vocal tasks, but if the psychological resistance is strong, psychotherapy may be necessary to maintain the more adult voice quality.
It is also possible that the post-pubertal voice does not develop because there is some physical problem with the voice at the time of the pubertal voice change, such as a prolonged upper respiratory infection or intubation. In that case, the disorder is not considered psychogenic and usually responds quickly and easily to functional therapy.