I Manage My Migraines By “Toning” My Voice — & It Works

Courtesy of Olivia Giovetti

It’s a Tuesday morning in 2016 and I’m lying on the bathroom floor of my office. The lights are out, the door locked. I know exactly how long I can stay here before someone notices I’m not at my desk, and I know how long I’ll need to be at my seat before I can come back in here again; before I can lie down in the dark with a damp paper towel on my forehead. Sometimes this routine makes up my entire day: sit at my desk, pretend to work, go to the bathroom, lie down for eight minutes, and then do it all again. I’d gotten used to this routine, having spent more than half my life living with chronic migraines. Though “living” would have been optimistic during some of the worst attacks.

My migraines first began when I was in high school, and I learned pretty quickly that complaining about the pain wouldn’t earn me any sympathy. My mother rolled her eyes whenever the school nurse’s office called. On days when I couldn't take it anymore, my grandfather would pick me up early from school and take me home, where I’d sleep them off for the rest of the day. It wasn’t ideal, but it was a routine I could live with.

Until I got to college.

Most of my professors’ policies stated that I could miss two classes per semester before my grade would be penalized. This wouldn’t be enough to accommodate my head’s knack for being totally normal one minute and then feeling like an exploding pinball machine the next. So I started to supplement with 800-milligram tablets of ibuprofen that my mother, a physician, prescribed to me. As big as the horse pills were, they didn’t seem to work. Nevertheless, for 10 years, I took them. In that time, I’d grown accustomed to the pills working only enough to cut down the pain, turning my migraines into a dull, steady ache. Toughing out the rest became my new normal.

To combat the pain I lived in, I learned to lie in order to call out sick from work. When I lived in Rome after college, my sister’s grandparents came to visit me for a week. After a few days of driving through the idyllic Italian countryside, I was a wreck. I was so cranky that they wrote me afterwards and asked if they had done anything to upset me — a heartbreaking email to receive after they’d flown across the Atlantic just to see me. It was clear then that “toughing it out” was not a long-term solution.

When I started a new job in 2017, moving from the music industry to a broader writing focus, all the stress that came with all major life change became too much for me to handle (and it also didn’t help that my new office didn’t have a single-occupant bathroom).

After I missed a morning meeting with my team early on, I took my boss aside to explain that I’d had chronic migraines for half my life. I stressed to him that I was fine and that only sometimes did they get in the way of my work. In those cases, he could count on me to make up for whatever I missed and didn’t need to question my dedication to the company. He surprised me by not focusing on my work performance, but on what I needed to do to get better. Turns out, he had the same issue.

“I’m setting a goal for you,” he said. At the time, I was averaging three migraines a week, so he challenged me to get that number below an average of two per week by the end of my first quarter with the company. I didn’t know if I could do it, but I was determined to try.

Changing jobs also meant changing my insurance, which forced me to find a new doctor and also gave me an opportunity to look for someone who would do more than tell me to keep taking the 800 milligrams of ibuprofen I’d been taking for 16 years. I wish I could say I did anything as thoughtful as looking up specializations, reviews, or asking for references, but to be honest I just happened to luck out on a ZocDoc search for a new general practitioner who took my insurance and was near my office. It surprised me when, before explaining my options to me one by one, she explained that taking this much ibuprofen may have been causing me “rebound” migraines, which, according to the Mayo Clinic, are “caused by regular, long-term use of medication to treat headaches, such as migraines.”

OK, I was saying. This is happening right now, and I can’t ignore it and I can’t fight it. So I welcomed my migraines in.

Around the same time, I was completing a sound meditation training program. I signed up for it on a whim, without any sort of healing for my migraines in mind. I was mostly keen to deepen my meditation practice and learn more about the ethereal instruments I’d heard used during sound baths — crystal singing bowls, tuning forks, chimes, etc. I was disappointed to learn our training would focus mostly on the human voice instead of instruments, because I hated the sound of my own voice. I was also a little skeptical when Silvia Nakkach wrote in our assigned course reading, Free Your Voice, that she talked to birds. Growing up in New York as the daughter of a physician, I was a dyed-in-the-wool skeptic, wary of anything that seemed too “out there,” no matter where it stemmed from.

But when part of the training required us to start a daily “toning” practice, I went all in. After all, Eastern spiritual traditions revered the power of the human voice long before the advent of Goop. Some of these traditions even predate Buddhism by thousands of years.

“Toning” your voice isn’t singing. It’s even more basic: inhale slowly and on the exhale, release a sound. The most basic toning exercises stop there, without any specific notes, vowels, or other instruction. According to the Foundation for Alternative and Integrative Medicine, intoning extended vowel sounds is supposed to help release energy blockages from the body, which helps facilitate the flow of energy through the body. “Toning” is a form of sound therapy.

The goal with this exercise was to feel it — really feel it. As Nakkach wrote in Free Your Voice, “the vibration of sound as it reverberates on the lips, in the head, and in the chest can affect the body and organs in a very healing way.” By making the right tone with one part of your body, she said, you can “shift” another part of your body towards a sense of holistic harmony, much like chiropractic or acupuncture.

As I began to carve out a morning routine, humming to myself for 20 minutes, I noticed how I felt after toning. I felt fresh and still buzzing, like a cathedral bell after it’s stopped ringing. I also noticed that, while I was still getting migraines, they were less extreme and fewer and farther between.

So I began to try something when I’d get these auras: I toned. I felt my seat on my desk chair, or my feet on the ground of the subway platform. I’d take a deep breath in, and let it out on a low, barely-audible tone.

My teacher, Sara Auster (who knew about my migraines), attributed this in part to toning. When you hum for a long period of time, she explained, the body’s response is to produce more nitric oxide. Nitric oxide (aka NO) is a gas molecule that is a fundamental part of our bodies, increasing blood flow and lowering blood pressure. Three American scientists Robert F. Furchgott, Ferid Murad, and Louis J. Ignarro — won the Nobel Prize in 1998 for their studies of NO and its ability to do all this by widening our blood vessels through relaxing their inner muscles (yes, blood vessels have muscles). This triggers our parasympathetic nervous system, which is the rest-and-relax nervous system that counteracts our sympathetic (fight-or-flight) nervous system.

And fight-or-flight is exactly how I felt when I sensed a migraine aura coming on. So I began to try something when I’d get these auras: I toned. I felt my seat on my desk chair, or my feet on the ground of the subway platform. I’d take a deep breath in, and let it out on a low, barely-audible tone. Despite all of my hesitation around talking to birds and using crystals in place of prescriptions, something happened. Something that seemed to be working. I felt better.

There’s science to explain this: Another nitric oxide study, performed by Eddie Weitzberg and Jon O. N. Lundberg at the Karolinska Hospital and Institute in Stockholm in 2002, found that humming helped to increase nitric oxide in the nose as much as 15 times the normal amount. Interestingly enough, however, is that science over the last 20 years has suggested that nitric oxide may increase migraines rather than decrease them. So why was my head doing the exact opposite?

Though I’m not a doctor, I’d wager it had something to do with the parasympathetic nervous system. Beyond science, there was something emotional happening for me. After spending more than half my life fighting and fleeing from my migraines — retreating into dark rooms; thinking I needed to hide them from doctors and employers because I’d be seen as weak; trying to tough it out — I was finally meeting them on their level, on their frequency. OK, I was saying. This is happening right now, and I can’t ignore it and I can’t fight it. So I welcomed my migraines in.

There’s an old story in Buddhism about the Buddha and the demon, Mara, who would try (and fail) to tempt him off the path of enlightenment. In one of their encounters, the Buddha was meditating while Mara entered the scene, hoping to distract him. “I see you, Mara,” the Buddha said, calmly. Instead of pushing this demon away, the Buddha invited Mara into his house. He treated Mara like an honored guest, offering him tea and giving him the most comfortable cushion. Mara, confused, stayed for a bit, and then left. Through toning, I was, in my own way, inviting my own Mara in for tea. Confused, my migraines stuck around for a bit, and then they left.

Toning hasn’t been a perfect cure. I still get migraines. And I still take medicine that my doctor has prescribed me when I feel one coming on. The prescription changes every few years, and what works now may not work for me tomorrow. What has worked for me consistently, however, is toning. I tone when I feel a migraine coming on, and it has been as helpful as modern medicine for me in understanding how my migraines fit into my life.

“We live in a world where we learn more about fragmentation than about wholeness,” Silvia Nakkach wrote in Free Your Voice, and so I welcome my migraines in versus shutting them out. Doing so helps me keep the harmony in my life. By taking a moment to listen — really listen — and responding accordingly, I’m better able to my way back to becoming whole again.