The situation repeats itself with a regularity Dr. Drew Pinsky cannot dismiss. The California doctor co-hosts "Loveline," a syndicated radio advice program heard locally on WHFS-FM ( 99.1). The show offers sobering help to troubled teens on matters of addiction and romance.
On most nights, Dr. Pinsky and his partner, Adam Carolla, field at least one a call from a distressed listener whose voice doesn't sound quite natural. She may be in her late teens or early 20s, but her voice sounds like that of a fourth-grader. Soon, after some questioning, it is revealed that the caller suffered some abuse as a child.
A childlike voice often is a clue to a traumatic past, Dr. Pinsky says.
"It's a strange phenomenon," he says. "I'm listening and looking at my hands or the microphone, and the voice comes on, and I think I'm talking to an 8-year-old."
With surprising accuracy, Dr. Pinsky can predict whether a caller has suffered a childhood trauma, perhaps sexual abuse or parental abandonment, based on hearing but a few words over the airwaves.
Doctors specializing in trauma say a person's vocal qualities can, indeed, change after they experience an abusive incident or series of abuses in childhood. The experts differ, though, on exactly how such information can be used in therapy and how often an abused person develops this condition.
Even Dr. Pinsky admits that little scientific evidence exists to prove what he hears. "I know of no literature that supports this," he says. His instincts, though, tell him his observations are correct.
"People that have traumatic experiences clearly develop developmental arrest," Dr. Pinsky says. "There's some reason to believe that vocal qualities that one has at the time of a traumatic experience tend to arrest as well."
The callers in question "have a coquettish quality" to their voices, he says, almost a Marilyn Monroe-esque tone when they speak.
A recent male caller evoked a similar reaction in him. "He was 29, and he sounded like a 14-year-old," Dr. Pinsky says. When questioned, the young man became "very defensive," he says.
Sylvia Marotta, professor of counseling at George Washington University, warns that such vocal conditions don't affect all who have suffered childhood trauma. Also, many people naturally develop voices with higher pitches than their peers.
From her experience, the vocal changes that trauma can spawn bear more of an "in and out" quality, depending upon the person's current mental state.
"If you're having a flashback, and it's to material that is traumatic in nature, you could get into the voice of whatever age you were [at the time of the trauma]," Ms. Marotta says.
Sometimes, a patient's voice can take on the opposite quality a harder, more mature tone if a therapeutic breakthrough is nearing. It's what Ms. Marotta calls an "a-ha" moment.
"When those things happen, they can be laden with some kind of intense emotion. There will be changes in timbre of the voice," she says.
The body's physiological response to terrifying moments may explain the initial change in vocal tone.
"You have activated the fight-or-flight response. It rechannels blood supply into the long muscles you need in your legs and feet to run away. It will have a different constricting effect in other areas," Ms. Marotta says.
In such situations, "the cortisol levels increase," she says. "When that happens, the biochemistry gets diverted, so we're able to do what we have to do and get ourselves out of danger."
The vocal tendencies of childhood trauma survivors aren't understood by some psychologists, says Judith J. Bucholtz, a marriage and family therapist in Los Angeles.
"I think people who specialize in post-traumatic stress are far more aware of it than those who don't," Ms. Bucholtz says.
Some people who have been terribly traumatized "regress emotionally and end up with a childlike voice; they're helpless," Ms. Bucholtz says.
The condition occurs in both boys and girls, but it becomes less obvious when a teen-age boy's voice deepens with puberty.
The body's reaction may have a protective element to it. "When [trauma survivors] feel somewhat vulnerable, they seem more childlike," Ms. Bucholtz says. "They elicit caring behavior [through the youthful voice]," she says. "It's seductive in a way that's a way to obtain some kind of help."
Psychological experts say research on this narrow field is rare, though Richard McNally, a professor of psychology at Harvard University in Cambridge, Mass, recently studied how emotions factor into a patient's retelling of horrific events.
Participants in one group had either panic disorder, a social phobia or major depression, while a second, control, group had no record of psychological maladies. They were asked to recall their most terrifying experience or panic attack. Later, they were told to share what they had had for breakfast to provide a neutral memory.
Researchers taped the narratives and content-filtered the speech, rendering it indecipherable in meaning. All the researchers could read into the voices were changes in tone.
The results showed that emotions clearly became evident from the testimonials from both the mentally troubled group and the control group when participants were describing frightening events.
"Emotion was leaking out into the way they were speaking, not merely what they were saying," Mr. McNally says. "The emotional experience of remembering is reflected in the voice qualities."
He says psychologists can use such findings to tap into how important an event might have been in a patient's life, independently of how the patient describes it, for a more accurate account of its impact.
"It's a clue to the person's emotional state," he says.
People with abusive histories often use childlike means as a coping mechanism, says Esther Giller, president and director of the Sidran Institute, a Towson, Md., nonprofit organization that helps those who have endured traumatic events.
"They basically go back to certain stages of childhood to cope with the world in a particular way," Ms. Giller says. That, she adds, can be reflected in how a trauma survivor speaks, but it isn't always the case.
"You can't say if someone has a childlike voice you can infer there's an abuse history by any means," she cautions.
A psychologist may note a patient's voice during the initial therapy sessions, she says, but that will be part of a much larger picture, including body language and the patient's overall emotional state. "It's an additional piece of information to help them understand what's going on," she says.
The vocal changes aren't physiological, but emotional. "You're not talking about a variation of the vocal chords," she says.
Ms. Marotta acknowledges Dr. Pinsky's observations but warns against concluding too much from a talk show that dabbles in therapeutic matters. "What you're really doing is 'infotainment.' You're not doing therapy," she says. "Your ability to make outrageous statements [over the radio] is huge."
To Dr. Pinsky's credit, he typically steers listeners to a therapist at the end of the phone call to better explore issues discussed on the air.
He says he does believe, though, that the condition can be ameliorated through successful therapy.
"It's reversible, absolutely," Dr. Pinsky says. "What therapy is, it's establishing renewed attachment and creating an intersubjective experience which allows for growth of the individual from wherever they left off. That's the whole idea."
Ms. Giller agrees, adding that therapy can arm trauma survivors with new skills to deal with modern conflicts.
"When a person is less stressed, or learned new ways of coping with stress, those new ways of coping can substitute for the ways in the past."
