How I Work with Neurodegenerative Voice with Somatic Voicework, Jin Shin Jyutsu and Functional Neurology: A Case Study

J is a jovial, bright teenager who came to me for singing lessons when she was 10. Now 14 years old, she suffers from a debilitating genetic neurodegenerative disease for which there is no known cure. She is currently on experimental medical treatment. Her parents did not present her diagnostics, despite multiple requests. As such, I had to work purely from my observation of symptoms.  On observation, she seems to suffer from cerebellar ataxia, which manifests in her gait and her voice. When she first started classes with me, she had difficulty starting the tone as she has a stutter. She could, however, sustain a tone for a short period of time, albeit with very compromised articulation. Conversational speech, though, was difficult as her stutter gave her a halting, slow tone, and the lack of control in her articulators made her slur.


Introducing our Modalities

Somatic Voicework (TM) is a functional voice teaching modality that focuses on restoring vocal function. Unlike traditional voice teaching methods, it believes that optimal resonance, pitch, vocal control, etc. are a result of good vocal function. Central to its tenets is the balancing of thyroarytenoid dominance with cricothyroid dominance in the vocal mechanism, said balance to be determined by the vocal task, e.g. classical singing, belting, etc. In our practice, we use singing to train desired behaviors such as sustained respiration, increased core strength, and better posture, to name a few, for positive benefits that extend beyond the voice studio.

Jin Shin Jyutsu (R) is a Japanese energy healing method rediscovered by sensei Jiro Murai at the beginning of the 20th century. Disharmonies in mind, body, and spirit are attributed to blockages in the flow of energy. Jin Shin Jyutsu (R) is a synergistic integration of Chinese medicine concepts such as the 5 Element Theory and organ function energies, with the chakra system and its own unique numerical system of 26 safety energy locks.

Our functional neuroscience tools analyse the over- and under-activation of parts of the brain and work on improving brain function by activating the under-activated parts and inhibiting the over-active parts. J’s never-say-die attitude inspired us so much that we trained in functional neurology with BodyHack UAE in order to help her get better. We recently added Neurologic Music Therapy (R) to our toolbox.


Working on Singing
J tends to fatigue easily, making most neural interventions, except techniques associated with Neurologic Music Therapy (R), difficult for her. As such, initial interventions involved the use of Jin Shin Jyutsu (R).

We found that getting her to hold her little finger during phonation improved her stutter in both singing and speech. The little finger is associated with the Heart and Small Intestine organ function energies in Jin Shin Jyutsu (R), which govern speech, the voice, and the proper functioning of the vocal folds. Holding her little finger helped us bypass her stutter in singing and move right on to the development of vocal technique.

Singing in belt voice register was used predominantly to build her respiratory strength, with high mixes to ensure the stability and strength of her core muscles and respiratory system to sustain breath support and phonation at the top ends of her range. This was in line with her goal to sing Contemporary Commercial Music.

Articulation consistently proved tricky in singing. Her articulators, in particular the hypoglossal nerve (CN XII), that control movements of the tongue were weak, with the trigeminal nerve (CN V) being recruited to make up for the loss of function. While articulation in singing was much better than articulation in speech, it was slow and slurred (although she sometimes did not think so!). I tried to work around this by giving her songs with a slower tempo e.g. ‘Can’t Help Falling in Love’ (Elvis) and ‘What a Wonderful World’ (Louis Armstrong). However, articulation would fall apart when singing songs that had to be delivered in a sing-speak quality, e.g., ‘Your Song’ (Elton John). In view of this, our approach was song choice that matched her tempo for clear diction, with sustained, long phrases, and a gradual increase when we felt she had improved.

Apart from her stutter and diction issues, her vocal control was excellent. She had accurate pitching, good breath support (with the use of Jin Shin Jyutsu (R)) and great control of dynamics.


Cerebellar ataxia: the connection between gait and voice

The cerebellum controls the body’s motor coordination. In ataxia, cerebellum function is compromised, which results in an unusual gait and, in J’s case, a generally clumsy articulatory system. (Please note that our assessment of cerebellar ataxia was purely from observation, as the parents were unwilling to share the diagnostics with us.)

We used breathing exercises to work on both her gait and hypoglossal nerve strength. We had her breathe in through her nose in 3 counts and out in 3 counts—a simple exercise done 10 times, in order to improve her articulation. The cerebellum and brainstem form a functional unit known as the ‘hindbrain’. Activating the brainstem will also activate the cerebellum and improve global motor coordination.


Posture, Gait and the Mediator Flow
The Jin Shin Jyutsu (R) Mediator Flow is one of the Trinity energy flows that criss-cross the body. Disharmonies in this flow manifest as twisting of the body. This flow is easily disharmonised by stress, emotional turbulence, and fatigue.

Aligned posture is crucial in singing to ensure that the respiratory, phonatory, resonatory, and articulatory systems function optimally. In J’s case, the twisting in her body from ataxia could also be energetically attributed to Mediator flow disharmony. Jin Shin Jyutsu (R) therapy managed to reduce the twisting in her body. Her gait was more balanced after therapy as well.


Singing and Speech
Before embarking on our Neurologic Music Therapy training, we approximated the techniques of Melodic Intonation Therapy (R) in approximating prosody with sung pitches, removing the pitches with J now speaking the phrases. This was a very useful exercise because J was starting to put it all together, associating her singing skills with her speech.

Currently, we are using Rhythmic Speech Cueing (R)-a Neurologic Music Therapy (R) technique that uses a rhythm (a metronome beat) to organise and cue the firing of motor neurons associated with speech. J’s speech speed is picking up slowly as she progresses.


J now speaks with a clear, albeit slow tone, punctuated with stutters from time to time. She is, however, a superb singer who belts out songs like ‘Into the Unknown’ and ‘Chandelier’ easily.

What began as our purely metaphysical modality (Jin Shin Jyutsu(R)) built on Somatic Voicework (R), has evolved into a new level of complexity and creativity, incorporating more neural tools, even as we seek more metaphysical ones to improve your experience. Contact us if you’re curious to try what we have to offer.

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