Mike wrote: . . . my impression was that the problem was not basically physical but mental.

I understood that and I think you’re right Mike. I call it “high anxiety”. ;-) I find that I have to distract my attention by “doing something” in order to avoid inhibiting ideation that creeps into my head. Simply put, if thinking is the problem, don’t think so much. But pain is not the best solution in my opinion because it is itself an unproductive distraction. I believe a better strategy is to replace the behavior with a more productive one. I’m thinking Pavlov here (no insult intended). We should develop a conditioned response by transferring anxious obsession to invoking release. Transference.
Warmest regards,
Les

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Often the issue with a vocal problem is mentally based. I am not going to speculate if that is the issue with this person. But we need to recognize that even a mentally based problem still translates into a physical inability to produce a higher pitch comfortably. The voice is a physical apparatus. That being said, the voice is a physical instrument that has a direct link to our mental capacity through the nervous system. So there is a definite link between how we think of doing something and how it gets done. Also, this link is a two-way street. So not only will how we think influence the doing of the action, as in a mental block interfering with the production of a high note. But if our body senses that it will not be able to produce the note because the physical coordination is not balanced and skilled enough then it will communicate that to the brain. So which came first, the chicken or the egg? I don’t know, but I know we need to take into consideration both sides of the issue if we want to solve the problem. If we just try to change the mental state without educating the body of the correct coordination we will never completely eradicate the anxiety of difficult high notes. And vice-versa. This is the basis of what Allan Lindquest called Security in Singing. The training of the total response of the body, mind and emotions in the singing act so they all participated to ensure our whole being is on the same page and working toward the same goal. He learned this in Sweden from teachers that worked with Garcia and Lamperti. So it is really the basis for much of the old Italian schools. I have read a quote of Lamperti’s that I use often that good singing is like thinking out loud. I think it is this relationship that he is talking about.