What are the possible causes of difficulty in making one's voice heard? The causes may be divided into those that are related to limitations of receptive capacity on the part of others and those that are related to limitations of expressive capacity on the part of oneself. An example of the former is deafness on the part of the listener or audience. An example of the latter is aphonia (loss or lack of voice) on the part of oneself.
The deafness of others to the sounds of one's voice (and to the significance of whatever one wants to say) may be literal or figurative. Figurative deafness on the part of the listeners or audience may in some cases be due to their preoccupation with other matters or their lack of interest in whatever one is saying. It may in other cases be due to their lack of understanding or their unwillingness to listen to whatever one is saying. It may in still other cases be due to their narrow-mindedness, rigidity, biased or intolerant attitudes, or tendency to make prejudgments about things.
Aphonia may similarly be literal or metaphorical. Physical causes of (complete or partial) aphonia include laryngitis, vocal cord nodules or polyps, vocal cord paralysis, laryngeal cancer, laryngectomy, spasmodic dysphonia, voice tremor, and neurological conditions such as myasthenia gravis, Parkinson's disease, and amyotrophic lateral sclerosis (ALS). Other causes of speech impairment include speech fluency disorders (such as stuttering), speech articulation disorders (such as lisps), dysarthria (which can cause slurring of speech), dysprosody (which can cause disruption in the intensity, rhythm, and intonation of speech), speech apraxia (which can can cause difficulty producing sounds and syllables in correct sequence), and expressive aphasia (which can cause decreased fluency of speech, decreased spontaneous speech, difficulty finding words in order to make verbal responses, difficulty naming objects, and difficulty producing complete sentences). Metaphorical aphonia, on the other hand, may be a socially-determined loss of voice that is caused by (psychological, moral, religious, professional, or legal) inhibitions, prohibitions, and deterrents against being able to make one's voice heard by others.
When one wants to say something and no one is willing to listen, one may in some cases be confronted by one's own unimportance, lack of social standing, lack of recognizable impact on the attitudes of others, and powerlessness to make one's voice heard.
Other people may in some cases refuse to acknowledge one's right to speak and may feel that their being allowed to speak is more important. They may in some cases have a vested interest in refusing to allow others to speak, or they may intrude on others' turns to speak, or they may simply refuse to listen, or they may be too busy to listen, or they may want to speak first and keep others waiting for their turns to speak.
There may also in some cases be socially or institutionally imposed silence (which may determine, to varying degrees, when and where a person is allowed to speak, and what she is allowed to say). A person may be silenced by implicitly or explicitly being told that her opinions don't matter or that a particular decision that affects her livelihood or well-being cannot be changed or revoked. She may be told that an undesirable state of affairs is a fait accompli, and that she shouldn't "rock the boat" or "make a scene" about it.
One may also be silenced by being held to a professional or vocational code of silence, by being made subject to a legal injunction against speaking publicly, by being subjected to censorship (political, religious, corporate, or professional), by being refused publication of one's views in print, visual, or broadcast media, and by not being allowed to read books, journals, newspapers, and magazines.
One may also be silenced by the effect of social norms that discourage one's speaking about particular subjects, feelings, and experiences. One may be deterred from speaking about particular subjects because of verbal and nonverbal cues provided by others regarding the topics that they desire, or do not desire, to discuss. One may also be silenced by having one's voice drowned out by louder voices or by a flood of other voices.
In some cases one may not be able to put one's thoughts into words or may not consider oneself to occupy a position of sufficient status for one's words to be taken seriously by others. One may not consider oneself sufficiently qualified to contribute something meaningful to public discourse, or one may not be used to speaking in public, or one may have to (literally or figuratively) strain to make one's voice heard, or one may be reluctant or unwilling to expose oneself to the possible ridicule, humiliation, or embarrassment that one may be subjected to whenever others reject or disagree with whatever one has to say, or one may be reluctant to raise one's voice sufficiently in order to make oneself heard if the audience appears to be distracted, uninterested, disorderly, hostile, threatening, or agitated.
Being unable to make one's voice heard may in some cases merely be a matter of being unable to find someone willing to listen. Finding someone to listen may often be more difficult than actually voicing one's thoughts and feelings, given that one may need to address a listener or audience of some kind in order for the utterance of one's thoughts and feelings to mean anything to someone other than oneself.
One may be able to make oneself heard by calling attention to oneself (through styles of speech, styles of clothing, nonverbal behaviors, behavioral mannerisms, etc.), and by lobbying, demonstrating, protesting, campaigning, and demanding that others address one's needs and concerns. One may also be able to call attention to oneself by engaging in public debate and by making public appearances in person or via broadcast media. Another way of making one's voice heard is to enlist the help of someone more recognized and well-known than oneself (such as a legislator, journalist, lobbyist, celebrity, public spokesman, or human rights organization) in order to give voice to one's needs and concerns.