Stuttering – In the first part of this post, I spoke about how I believe that stuttering/stammering is like a vine, that has wrapped itself around every aspect of your being, and in order to remove the influence of stuttering/stammering from your life, you not only need to look at using some of these mainstream speech therapy for stuttering approaches, but you also need to understand how these vines have formed, and how they influence your behavior, and then how to go about removing them. In this part of the post, I talk about one of the main vines that holds stuttering/stammering in place, and that is the vine of fear.

Fear
The innate emotion at the base of all anxiety is fear. We don’t have to learn
what fear is, as our brain is programmed to recognise what is a threat to us, and to trigger various reactions in the brain, to cause us instantly to react, to remove us from the stimulus causing the fear. This can be a physical threat, or an emotional threat to our wellbeing. It can be real and/or it can equally be perceived. Either way, fear will cause a reaction in our brain, and that reaction will cause both a physical and mental response in our body. As people who stutter, this reaction heightens our anxiety to some extent, either mildly or severely, but what is known is that that heightened anxiety, contributes to our degree of stuttering. If we realise then that fear leads to anxiety (or even panic), which in turn leads to increased speech dysfluency, then it is natural that to reduce fear, will result in less anxiety, and less dysfluent speech, and of course a more enjoyable existence. So if fear is at the route of our speaking anxiety, then how can we replace it with an emotion, that is more resourceful to us? What is a feeling that we could engender within our self, that would help to replace feelings of fear? What are we fearful of when speaking to other people? For various reasons, too complex to go into here, we are fearful of how we are being perceived and judged by others, and what that may mean in our life, and how that makes us feel in that moment. In most cases it is illogical, that we have fear when we are about to speak to another person, so if there is no logical reason to fear others, then we need to learn to get ourselves into a state which is as far removed from the state of fear as possible.

Many would argue that the opposite of fear is courage, but from a spiritual point of view, the opposite of fear is love. When you are in a state of love there is no fear, and the same can be said for the many degrees of love. You feel a closeness towards that person, a feeling of mutual respect, admiration and trust. In this true state, there is no feelings of judgement, only acceptance for each other.

So how can we invoke this state, when we have allowed ourselves to develop a mind-set, where we feel everything except love towards our fellow man, especially when we are required to speak to a stranger, or person in perceived authority? Can we change that mind-set? Do we want to, and why should we? Can we afford to, or do we open ourselves up to having our feelings hurt if a more open, interpersonal relationship in our communication style is not reciprocated?

From a spiritual point of view many would argue that we are all connected, and that we all share a spark of the supreme soul, but I do not want to go into that in this post other than to say, it will be resourceful to you to try to look at other people, who you are about to communicate with, as though they were your very best friend, or even your lover. It will be resourceful to you, to look beyond the face, or the tone of the voice of the person you are speaking to, and try to see the soul behind that individual. Their soul that is pure love. Now you may argue, that some of the people that you have to speak to, show a nature that is the furthest thing from love, and some even border on pure evil. Well that may be the case on the outside of a hardened persona, but deep down there is a person inside all of us, that just wants to be loved. Look for that, and speak to that in the people you speak to, and it is very likely that it will be reciprocated, and at the very least, it will lower your anxiety about speaking to that person. Now whether you accept that or not is irrelevant. What is relevant, and will be very helpful to you, is to try to approach every person you speak to, as though you are going to talk to yourself in a mirror, or about to talk to someone who loves and or respects you for who you are. As mentioned above, you will find that you approach the communication situation, in a totally different state of mind. A state of mind where fear is gone, or at least minimised, and as a result your stuttering and speaking anxiety, will be greatly improved, whether it is a one on one communication situation, or communication to a group. Why would your mind be consumed with thoughts about how others are judging you, if you have flooded it with thoughts of love for all who you speak to.

How can I feel that way towards all people, you say? Why would I want to? You have not met my boss! You have not met my father! You have not seen how they laugh at me! It is not about giving the other person something that they have not earned, or are not entitled to, … your love. It is about you freely giving yourself the same thoughts that create a feeling of love, instead of freely giving yourself thoughts of fear, which your mind is going to use, to subconsciously govern your body to act on, and throw you into a state of anxiety, where your body believes you are going to either have to fight, or flee, from this other person or group of people.

You must understand, that you do not know how the other person is judging you. You think you do but you don’t. What you are perceiving are your own thoughts, so why not have loving thoughts in your head. It will certainly drive out fear in many areas, other than just thoughts that relate to speech. It is something worth trying. What have you got to lose, really? It is an approach to life that, like the other vines that hold your stuttering persona in place, will not only benefit your speaking anxiety and speech dysfluency, it will improve the whole way you see the world, and the way you move through it, with ease and grace. What I am saying is, that rather than try to put yourself in this alien state of love and appreciation for the other person only when you feel anxious, you need to try to remain in this new state as much as you can, which will mean that you need to be conscious of your ongoing emotional state as much as you can be.

So how do you achieve this? Well these tips will help.

1)      Always smile when you go to speak to another person.
2)     Look into the other person’s eyes, and try to see the loving soul that resides within.
3)     If you experience less than a loving reaction from the other person, accept it, and realise that it is more about them, and their concept of how the world is in that moment, rather than about you and how you, and your perceived influence on others, and how you believe your expectations should be met.
4)     If you experience a less than loving reaction inside yourself, and less than loving or accepting judgemental feelings towards yourself, as a result of the interchange, try to see the other person as having helped you find your own triggers for negative emotions, and use those experiences to work on changing your emotional reactions to others behaviour, in such a way that such perceived negative behaviour, does not influence your internal chemistry, in a way that negatively effects your anxiety level and feelings of love towards all other people. See those who help you find your emotional buttons, as your teacher, not your enemy.
5)     Try to look for the good in all people.
6)     Try to respect that everyone has the right to control their own emotional reactions, whether it be negatively towards others or positive, and that you have no influence over their behaviour, only your own thoughts and resultant behaviour.
7)     If people laugh at you or mimic you from time to time, realise that it is only their reaction to something that puzzles them, and is in no way a true reflection of how they see you, as a fellow human being.
8)    If people finish your words or sentences for you, realise that communication is all about getting thoughts from your head into the other persons head. It is only natura, that when people believe they have the message, they react on it. People are not obliged to wait for you to finish, when you are obviously showing signs of difficulty in getting the words out. You must love and respect all people, and not judge them for the way they appear to you, otherwise YOU are being the judgemental one, in being upset that YOUR expectations have not been met by that other person.

Allowing fear to take control of any part of your life, is not the way our creator meant for us to live our lives. This is born out by words in the Bible, where it is said that “through fear, all our lives we are subject to bondage” (Hebrews 2:15).

Anger and Expectation
Anger is an emotional response that all of us feel from time to time, but it is not a state that we should choose to go into if we can help it, as it will rob us of rational thought, and control over our stuttering behaviour, and consequently our ability to communicate well with others. If you are trying to work on controlling your stuttering, anger may give you a level of short term fluency, but it will ultimately lead to increased dysfluency. So what leads to anger.

Two of the main causes of anger are:

1)      A feeling that our ego is under attack.
2)     Our expectations not being met, and our frustrations about that.

We all know that our ego can sometimes get in the way of engendering harmonious relationships, but we are not always aware that unfulfilled expectations are one of the main causes of frustration, that can lead to anger. Our expectations of what other people should do or say, will rarely be met, as we are all different, so to allow the fact that your expectations may or may not be met, to rule your emotions, is allowing anger to enter into your life more than it should, and interfere with your quest for calmness and awareness of mind, and fluency of speech.

Finally I would like to add, that harbouring anger, and failing to forgive others for their failings and indiscretions in communicating with you, will not only cause increased anxiety in you, but can also lead to dis-ease! Just remember that.

Now that was all a bit controversial, and everyone may not relate to or agree with what I have said, but I wanted to write that anyway for those of you who can appreciate and learn from that wisdom, as I have. In future posts I will get back to talking about more main stream approaches to treating the symptoms of severe and chronic stuttering. In the meantime, I again urge you to subscribe to my RSS feed or email notification, so that you do not miss posts about subjects and content that you will not read anywhere else. If you found this post useful or thought-provoking in any way, please make a comment.

I have spoken briefly in previous posts, about the different forms of speech therapy for stuttering that are available to people who stutter, and I have also spoken briefly about the various methods of approaching the psychological side of stuttering/stammering, but are you aware that you can alter your experiences associated with stuttering/stammering, (and speaking anxiety in general), by actively altering the way that you see and interact with other people, and the world around you.

I believe that stuttering is like a vine that has wrapped itself around every aspect of your being, and in order to remove the influence of stuttering from your life, you not only need to look at using some of these mainstream speech therapy approaches, but you also need to understand how these vines have formed, and how they influence your behaviour, and then how to go about removing these vines. These vines are made up of issues to do with:

1) Judgement
2) Perfection
3) Expectation
4) Power
5) Control
6) Acceptance
7) Approval
.8) Fear

Now this is by no means an exhaustive list of what I believe make up the vines that hold stuttering in place, but I believe that they encompass many of the major issues that we all need to look at. As mentioned, this list is not exhaustive and each of us will have additional vines specific to our own persona, but I think what I have to say here, will get you thinking about the type of individual emotion or behaviour, that could be holding stuttering and speaking anxiety in place for you. You are unlikely to read this anywhere else so let’s go slowly and look at these in turn closely.

Judgement
Judgement makes up one of the main vines that holds stuttering in place. When you are speaking in a dysfluent manner, you are invariably engaged in running a “mind reading” program in your head, while at the same time you are trying to operate a communications program. This mind reading that is going on is a process of assessing how the other person, and any secondary or adjacent listener, is judging you while you are in the process of speaking, and more likely, stuttering. This additional program that is running, may account for some of the unusual brain activity witnessed in the brain of a person who is stuttering, as this program is highly, and probably abnormally, active while we are speaking. Now we all think we know exactly how the other person is judging us, and the fact of the matter is that, for all intents and purposes, in our world, we DO know what the other person is thinking. So how is it that we know how we are being assessed or judged? Well the real fact of the matter is that we DO NOT know what the other person is thinking at all, and if in fact they are judging us in a positive or a negative manner, if there is any judgement going on at all. What we are certain of is our own perception of judgement by the listener towards us, and that is all that really counts in our concept of what is real. The fact of the matter is that the toxic judgements that we are experiencing, are in fact our own judgements of our self, that we are bouncing off the other person back at our self. Now this does not only apply to people who stutter, but every one of us when we experience some form of performance anxiety e.g speaking in front of a group. So why is it that we judge ourselves negatively, and how can we correct this errant thinking. Well it is perception of our own experiences in life, but more so it is a reflection of our own personal ethos and approach to life. If you are judgemental in your thinking towards others, who display some form of disability or unusual behaviour, then to that same degree of judgement will you apply it to yourself, through the eyes of others. If you are judgemental of others, you will surely use that same criteria of standards to bounce your own judgemental thoughts about yourself, off the other listener to that same degree, and depending how toxic those thoughts are, your level of anxiety about that judgement that will affect your speaking performance will follow. You may want to read that again, to ensure that you have absorbed what has been said there, as it is VERY important to understand and embody from this point on. The secret to unwinding this vine, that is holding your stuttering in place, is to look on all fellow humans for what they are, a fellow human, who like you, experiences a range of emotions, including love, and never attempt to pass a judgement on them in any situation. Human existence is a tapestry of dichotomies and differences. Behind those eyes or that voice is a soul that is connected to your soul, and any behaviour you experience, both acceptable or unacceptable to you, is just “you on another day”. It is behaviour that you yourself have demonstrated, or are likely to demonstrate in the future at some time. If you must judge, judge others for the differences and uniqueness that God has given them, in a positive and accepting way, and you will soon find that you are judging your own, less than perfect speaking behaviour, in the same more accepting way when you speak to others. By beginning to live your life with a less judgemental approach to others, you will begin to remove one of the major vines that is holding your experience of stuttering in place.

Perfection & Expectation
Another vine that is holding stuttering in place in your psyche, is the concept of perfection. Many of us have the illogical concept in our brain, that certain activities must be executed in a more than socially acceptable or perfect manner. Perfection is a result of fear. We believe that our speech pattern has to be perfect in any particular situation, otherwise we will not make the desired social impression, and we have a belief that that is bad, and will result in an undesirable outcome. The result of this is procrastination and avoidance. It is the content of your mind, not the speed and fluency of your delivery, that is what is important. Whether you are a person who stutters or not, aiming for increased knowledge is achievable, perfection in speech delivery is less achievable for the majority of us, so should be viewed as a skill that we may or may not have, not a prerequisite for social acceptability. Aiming for perfection will add to your speaking anxiety, add to your procrastination in moving forward in any situation, and add to your avoidance behaviour in situations where you do not believe you will be able to reach your expectations. If your expectations are too high, or are not reasonable given the facts that operate in any situation, then you are just continually setting yourself up for frustration and disappointment, however that manifests itself in your behaviour and your speech. Shed the vine of perfection by practicing some deliberate dysfluency. Although the logic of deliberately being dysfluent may seem a foreign concept to you, it is totally different to the normal stuttering behaviour that you experience, in that in the “real” stuttering moment you are “out of control”, and in some cases at the exact moment of the speech block your “awareness” is not fully present. In a “deliberate stuttering” situation, if it is performed correctly, you are “in control” and your “awareness” is present. You are able to see that imperfection in speech delivery is something that most people overlook, especially if you give them the vibration that you are OK with it. Shed the vine of perfection, and bring your expectations in line with the reality of the situation, and further remove one of the supporting vines that holds stuttering in place for you in your world.

Power & Control
Another set of vines that tend to hold stuttering in place are issues to do with Power and Control. Many people who stutter, are reluctant to exercise a level of power and control in their life, out of fear of how it may impact on them in the eyes of another. Many people who stutter tend to figuratively see a verbal exchange as taking place on a small mountain, where one person has to be on top of the mountain, while the other has to be on the bottom. In any verbal exchange many people who stutter, tend to subconsciously assess who should be on top, and who should be on the bottom. Invariably the person who stutters tends to place themselves on the bottom and, figuratively speaking, hand control of the situation to the other person, who they have given their power to, and place them on top. In many cases it is akin to handing the remote control that determines your behaviour, over to the other person. In many cases there is no logical justification, as to why the other person should be given control of the situation. It could be for as little a subconscious reason as their assertive or authoritarian look, or the tone of their voice, but more likely their perceived authoritative position. Invariably after some form of treatment for our dysfluency, we often manage to place ourselves on the top of this fictitious mountain, only to feel most uncomfortable in this position, and thereby placing added stress and anxiety on ourselves. Many of us choose to subconsciously gravitate back to the bottom, where we feel more comfortable, and this is one of the less understood psychological factors that leads to the concept of stuttering relapse. Allowing the vine of power and control to dictate your response, in any speaking situation, places unnecessary performance anxiety on you, and the result for a person who stutters, is increased dysfluency. It is better to see the situation in a way that there is not one mountain, but a mountain for each person. Each person is on his own mountain rather than one on top and one on the bottom. If you must see the world as a single mountain, when you are in verbal exchange, then take the position of power on top, but exercise that power with understanding, compassion and empathy and do not try to control and manipulate others to your own benefit. The power and control vine holds your stuttering behaviour in place, by making you feel uncomfortable whenever you are speaking to a person who perceptions have you believe is in a position of authority. Accept that you have the right to your own level of power and control in these verbal exchanges, and shed this vine from the mix, and further loosen the grip that stuttering has on your sense of self.

Acceptance
The next vine I would like to talk about in this post is that of acceptance. In order to begin to remove the vine of acceptance, we must first accept what is. We must all learn to start from a base of acceptance of what is. No matter what it is in your life that you are not happy with, you must first deeply and completely accept its existence as a fact. If you are a person who stutters, you MUST accept that fact. If you cannot accept it as your reality, then you will continue to hold it as your reality when you start to try to loosen its grip on your life’s direction. Not only must you privately accept this fact, but publicly accept it as well. If you refuse to accept the total reality of your stuttered speech, and speaking anxiety, you will always be trying to hide it, ever if you learn to control it. If you are a person who stutters, and are attempting to use a technique to try to control your stuttering, you will always oscillate towards trying to hide it by trying to “sound normal”, or trying to “sound like the other person”, instead of doing what you need to do to control and improve your fluency. Accept your situation and this vine will also begin to lose the support it is giving to your dysfluency problem.

Approval
We all seek some degree of approval, but as a person who stutters this need for approval can often work in a counterproductive way, in that whenever we believe that the listener may not approve of what we are about to say, we increase our anxiety level and the result is invariably greater dysfluency. It is OK to not receive full approval for our opinions, and for what we have to say. No one is always going to agree with what you have to say, and no one is going to always like what you have to say, but if you respect others, speak to them as you would have them speak to you and speak from the heart with others mental welfare in mind, whenever possible, you can remove the vine of approval that is another support surrounding your stuttering.

In the next post I will talk about the most important vine of all. That of fear and how you can seek to remove fear not only from your speaking environment but also from you life in general. In the meantime, I again urge you to subscribe to my RSS feed or email notification, so that you do not miss posts about subjects and content that you will not read anywhere else. If you found this post useful or thought-provoking in any way, please make a comment.

Cognitive Behaviour Therapy, (CBT), is a behavioural approach to addressing thoughts and feelings that lead to anxiety, and, in the case of the person who stutters/stammers, social phobia. CBT is increasingly being used as a tool to treat stuttering/stammering, based on the premise that stuttering/stammering is aggravated by anxiety, and in many cases this anxiety level can be managed, especially if the anxiety is related purely to the belief, that the person might stutter/stammer, and what that will mean to them.

Having said all that, I do not believe that CBT is a viable approach for ALL people who stutter especially those who have severe speech blocking. I believe it is better suited to those people who I would rate as a mild stutterer (1,5 or 1,4 on the Stuttering Jack Scale of severity). That is, people who are low on the actual physical scale, but high on the psychological scale of severity. This includes what we would refer to as covert stutterers. So a person who has mild and irregular speech dysfluencies, but high psychological reactions to incidences of dysfluency, is more likely to benefit from CBT, than a person with severe and constant dysfluencies. This is an example of how it is most important, that we have some form of scale, when talking about stuttering. For to say that CBT will definitely help “stutterers”, is a misleading statement. You might be interested in reading my first two post on this subject.

Research has shown that the parts of the brain that control anxiety, are linked closely to the areas that control speech, so it is not unusual that anxiety levels effect speech fluency. Anxious thoughts that a person has about how they might be being judged by the listener, will invariably contribute to a degree of stuttering, as the focus is taken off the conversation and put onto anxiety provoking thoughts. It goes without saying, that if we can take the focus off these distracting thoughts, then they will no longer have the anxiety producing effect that they are currently having.

It must be understood, that our thoughts and feelings are so important in determining our emotional state, and the way that we see the world around us. If we want to change our behaviour, we must first look at how we are thinking. By changing the way we think about a speaking situation, we can change the experience that we have in that speaking situation. Recognising this can be a break through for some people.

CBT therapy, teaches the person who stutters to look at the thoughts that they are having and attempts to have the person see, that those toxic thoughts, invariably have no basis in fact, logic or experience, so should be negated in moving forward into the speaking situation. If thoughts can’t be negated, the aim is to learn to challenge those thoughts with a view to altering them to less anxiety provoking thoughts, when facing a particular speaking situation. Once again this is more easily achieved for mild or covert stutterers than chronic overt blockers.

The CBT practitioner, talks about the different types of thought groups that can create increased levels of anxiety. These thought groups include, unrealistic standards of social performance, unrealistic beliefs about the consequences of poor performance, and, unrealistic negative beliefs about oneself. These thoughts lead to a level of perceived negative evaluation from the listener, and, lead on to social phobia, which can be a more difficult extension of anxiety to address.

After the individual begins to understand the role that thoughts and emotions play on our feelings, and, how that effects our anxiety level, which in turn effects our degree of stuttering, he then moves onto identifying the specific thoughts, that are causing the problems to do with his own individual speech.

When a problem thought is identified like, “if I stutter people will laugh at me”, or, “if I stutter no one will employ me”, or, “if I stutter they will think I am incompetent”, or, “if I stutter they will think I am weird”, the individual is taught to challenge that thought, by asking the following eight standard CBT questions about the thought:

1) What evidence do I have that the thought is correct?

2) What evidence do I have that the thought is wrong?

3) What would I tell a friend, if they had the same thought, that would help them?

4) What would a very understanding and supportive friend say, to help me eliminate this thought?

5) Do I think I am worrying unnecessarily about something, that I have no control over?

6) How does the thought make me feel – good or bad?

7) Would there be benefits to me giving up thinking this thought?

8 )  What is the worst outcome that could occur, if this thought were true?

The individual is quite often encouraged to carry a notepad with them, and when a negative thought enters his mind, that is causing anxiety, he is encouraged to ask these questions about the thought, until he is able to consciously replace the thought, with a more resourceful thought based on evidence, and the anxious behaviour is diminished.

A CBT program generally continues to talk about how we tend to use “safety behaviours”, like avoidance, so that our feared situations do not actually occur. Through such behaviour, we are continually reinforcing our feelings about the feared situation, by instantly gratifying ourselves with reduced anxiety, from applying our own individual form of safety behaviour. CBT theory argues that unless we face our fears, we will never give ourselves the chance of seeing that our assumed outcomes of the situation, are invariably wrong, illogical and even abnormally catastrophised.

There is a natural response to the fear stimulus, that is often referred to as the “fight or flight” response. Whenever we are faced with a feeling of fear, the brain throws the body into an automatic, almost reflex response, and the natural reaction to this is invariably avoidance. This can, over time, lead to a level of social anxiety in the person who stutters. When faced with the thought that we will be judged negatively by others, it is not unusual to choose avoidance, as the easiest option. Having said that, if avoidance is not giving you the outcome that you truly desire, the best strategy to adopt, is to face your fears in these speaking situations, to discover the real outcome, rather than your imagined outcome. For it is only through facing fears, by moving outside your individual comfort zone, that fear and anxiety can ever have a chance of being reduced. It is often said in CBT that, “thoughts or predictions are NOT facts”.

Frequently, CBT involves self imagery or visualisation, where the individual is required to imagine that he is in a feared speaking situation. While in such a situation, he is asked to become aware of the images that he is producing in his head and describe what he sees, both in his own behaviour, and the behaviour of the listener. If the image is what would best be described as, “negative”, then the individual is encouraged to re-imagine the situation, in a more positive, or less negative way in an effort to override the negative experience.

CBT also seeks to address the perceptions that we have about the opinions of others. The main perception that is addressed is the perception of approval, or, disapproval. Invariably the person who stutters believes that the listener will disapprove of his stuttering. The CBT practitioner will explain that, only your thoughts can create the emotional disturbance that make you feel uneasy, as a result of a social rejection, or negative evaluation. Perceptions are within your own power to alter, and your own perceived negative evaluation only gives the listener power over you, that you have given them. If there is any actual negative evaluation, it is generally not about “you”, but more about the person doing the evaluation.  The concept of “predicting”, is also addressed as we tend to predict the worst, with quite often no justification further adding to our anxiety level.

The typical CBT program then goes onto address the common issue of social perfectionism, as another form of social fear. Aiming for perfection, invariably leads to procrastination and avoidance. We can often become overly worried about what other people think of us, if we make a mistake or if we stutter, and this, once again, leads to avoidance, procrastination and excessive use of safety behaviours. Having a perfectionist approach to speech fluency, will increase anxiety and stuttering, as it makes the speaking environment very stressful. It is a useful exercise, to pretend that you are writing a letter to yourself or a friend, explaining why it doesn’t matter what other people think of you.

Social perfectionism, is addressed in CBT by encouraging the individual to deliberately make a mistake. In addressing stuttering, the mistake would be to deliberately stutter. This can be very difficult for the social perfectionist, but continuing to avoid certain speaking situations, only gives strength to the avoidance, and only by facing the situations that one avoids, without safety behaviours, will one understand that their behaviour itself, is invariably reinforcing the fears.

Another area generally addressed as part of a CBT program, is our perception of how things “should be” in our concept of the world. Are your individual perceptions resourceful to you, or not resourceful to you? Are they creating a situation where failure is inevitable, where you feel shame and frustration? As part of this process, post event analysis is quite often discussed. Are you continually going over in your mind the failures that you experience? Continually reliving your failures, only seeks to reinforce them as part of your future thoughts. Rescripting these events, to more resourceful imaging in your mind, will facilitate the brain, in remembering the preferred outcome you were really seeking.

As mentioned earlier, CBT has the possibility of being helpful for the mild or covert stutterer, who tends to catastrophise the possibility that they, “might”, have some infrequent experiences of dysfluent speech, and what that means to them. But, I believe, it will prove to be less helpful for the overt and chronic stutterer, with years of “experience”, that confirms his beliefs, about the effect of severe stuttering on himself, and his listener. This person “knows”, what will happen, and, “when” it happens, and, “how bad” it happens, and, what the outcome generally is. This is not imagined or catastrophised. It is no good telling the chronic stutterer, that his stuttering will not make a negative impression on the listener, when his life’s experience confirms his belief. It is no good telling the severe stutterer, that people will not treat him differently, if he has severe and repetitive speech blocks, when his experience confirms this belief. It is no good telling the severe stutterer, not to worry what others think, when he is really concerned more about his own judgement of himself. This is especially true if he is fluent in many situations and is able to experience the world as both a fluent and dysfluent speaker. Sometimes avoidance and other safety behaviours are a more peaceful way for the severe stutterer to live than continually putting her hand into the fire to see if she still experiences pain. CBT practitioners, working with severe stutterers, need to be reminded that stuttering is more about neural deficits in the brain, and less about cognitive processing. Having made that comment, it is fair to say that CBT is more about altering the pychological experience of stuttering, not the physical experience of speech dysfluencies, and in that regard anything that can make the experience of stuttering less painful for the stutterer, is worth giving a try.

One final comment. I do believe that CBT can be used successfully in treating severe stutterers, if it is implemented as a fluency shaping program add-on, to assist the individual, not to accept their stuttered speech, but to accept their new way of speaking, which for some, can be as hard to accept as the stuttered speech. I will talk more about this in a future post on the key aspects of conducting a successful fluency shaping program.

In the next post I will talk about NLP and Neuro-Semantics, and how they can have an equal or greater impact on the psyche of the person who stutters. In the meantime, I again urge you to subscribe to my RSS feed or email notification, so that you do not miss posts about subjects and content that you will not read anywhere else. If you found this post useful or thought provoking in any way, please make a comment.

In my last couple of posts, I have spoken about the psychological side of stuttering/stammering, and how our fear of speaking anxiety, is largely as a result of the perceived consequence of speaking with dysfluent speech. I spoke about some of the typical destructive and fear of speaking anxiety provoking consequences, that we can conjure up in our mind. This type of thinking has been referred to by some as “stinking thinking”.

Thinking this way is not resourceful to us. It is guaranteed to make us stutter worse, because of the consequence that we place on being dysfluent, in these situations. For example, “if I stutter in this job interview I will definitely not get the job because everyone hates stuttering people”. If you layer that with further negative thinking like, “ if I cannot get a job I will have no income”, and then continue to add to that further layers like, “if I have no income I might become homeless”, “if I am homeless I may not have any food”, “if I have no food I will die”. Now obviously we are not conscious of layering these thoughts onto thoughts, but we certainly do it subconsciously, and in a fraction of a second. If we do not recognise, and accept, that many of our fears, subconsciously layer themselves back to the “fear of death”, we will not understand why there is such fear and anxiety, associated with having some trouble in getting words out of our mouth, and into the other person’s head. We are born with an innate belief, which is often confirmed through our childhood experiences, that those who are “obviously flawed” in some way, are often singled out and marginalised, or “sacrificed” in some way by the group. So there is a deep fear there within every human being, of being seen to be “different” when we know we are otherwise. Such thoughts, if allowed to run rampant in your head, can lead to panic attacks, or at the least, a constant high level of anxiety, and can totally control the direction in which your life progresses. Can all fear be traced back to the fear of death? At the deepest layered level “YES”. This is a key understanding that you must have, if you are to alter your innate and reflex thinking, about situations where you are allowing the consequence of your dysfluent speech, to determine your anxiety level. You must learn to intervene at the base thought, so that increasingly toxic thoughts, do not escalate the consequences of dysfluent speech to the point where they send your speech spiralling out of control and into uncontrolled avoidance, shame, embarrassment and panic, which ultimately leads to ever increasing levels of stuttering.

If we accept that creating negative consequences, of dysfluent speech, are leading to higher anxiety, and that these consequences, are as a result of our own thoughts and feelings, and that we can change these thoughts and feelings, then we can start to look for ways to make these changes.

So how can this be achieved? There are various methods that have been, and are used, to train people, not only people who stutter, to look at the validity of their thoughts and feelings.

The first of these is a process known as Cognitive Behaviour Therapy, also know as CBT. CBT teaches the individual to look into and analyse the negative thoughts, and the negative consequences, that they see a particular action will have, and look for the real validity in those perceptions. Ideally the CBT practitioner helps the individual to see that there is no validity in the analysed perception and that the thoughts were in fact illogical to varying degrees and lack substantiation. In this case the thoughts revolve around stuttering. For instance if the individual may have the perception that if he blocks and stutters, the listener will think he is “retarded in some way”, or, “of lesser intelligence”, or, “not telling the truth”, (see the list of general consequences in my last post). Closer analysis of these thoughts are aimed at revealing that there is no evidence to support them as truth. By getting the person who stutters, to see how unfounded or illogical these thoughts are, by constantly asking what evidence they have for these perceptions, one can learn to replace these thoughts with more logical, and more personally useful thoughts, and so lower the speaking anxiety level.

The second and less known process, is known as Neuro-Semantics, which is an offshoot of a process known as Neuro Linguistic Programming, also known as NLP. This method works on the premise, that if you can speak fluently in any particular situation, you can learn to speak fluently in all situations. To do this, you need to learn to identify the “state of mind” that you are in when you are fluent, and the different states that you are in when you are blocking and stuttering, and then learn to step into that fluent state of mind, at will. It works on the premise that stuttering is a “thinking problem”, that manifests in a “speaking problem”. Neuro-semantics seeks to change the meanings that you have given to certain events, in your life experiences, from being fear based to being more resourceful to you. The premise is that blocking and stuttering is panic and anxiety expressing itself in the muscles that control speech. Just like a panic attack, a speech block is triggered psychologically. This work has been pioneered by Dr Bob Bodenhamer, in consultation with Michael Hall, both master practitioners in NLP and Neuro-Semantics. The theory and practice involved in mastering these methods of reducing speaking anxiety, are not simple to understand and put into practice, so guidance from a master practitioner in this method is advisable, but hard to find. Thankfully Dr Bodenhamer, has published a book on how to understand and apply this process, which for the cost of a weeks supply of Pagoclone, would be a very worth addition to your “toolkit” to attack speaking anxiety and stuttering. The book is called, “Mastering Blocking and Stuttering”. I personally believe that Neuro-Semantics starts off where CBT leaves off and is a more powerful process.

There are other methods of addressing the psychological side of the personality, that has developed wrapped in the “vines of stuttering”, and one of those is Personal Construct Therapy, also know as Narrative Therapy. In simple terms, that method looks at the way that the person, has constructed their whole persona as a person who stutters, and endeavours to address the difficulties that the person faces in developing the persona of a fluent or more fluent speaker.

Other methods include visualisation, meditation and modalities that seek to remove the emotions and trauma trapped in the energy fields of the body, as a result of stuttering experiences and other personally disturbing experiences, that contribute to your reflex fear and anxiety levels. These methods include such emerging modalities as, “pranic healing”, and, “emotional freedom therapy”, also known as EFT. But once again, these are all topics for coming posts, so I again urge you to subscribe to my RSS feed or email notification, so that you do not miss posts about subjects and content that you will not read anywhere else. If you found this post thought provoking in any way, please make a comment.

In my last post, I spoke about the components that make up the fear of speaking anxiety level of a person who stutters, and I pointed out that irrespective of whether you have had some speech therapy for stuttering to alter the “probability of stuttering”, you need to work on the component of, the “consequence”, of the, belief, that you are about to block and stutter. In this post, I will talk about how we as individuals, determine those personal consequences, but before that I would like to comment on anxiety in general, and the role that it plays in determining the severity level that stuttering occurs at.

I was reminded by one of my readers, that there are different triggers for anxiety, and that in my last post, I mainly spoke about anxiety that we experience that relates, directly, to our expected performance as a speaker. There is of course general anxiety, that has nothing to do with our speech. Having said that, all anxiety, whether it is speech related or general, is still a factor in determining the, probability and consequence, of speech dysfluency, and we will talk about all that now.

Most people suffer from stress and anxiety, to some degree, and the effects of stress and anxiety effect people in different ways. One of the ways that stress and anxiety effect people who have a, propensity or tendance to stutter, is that they are more likely to stutter when their anxiety level goes above, what I call, their “stuttering threshold anxiety index level”. Why this is, is not fully understood, but some believe that under stress and anxiety, the demands required to produce fluent speech by a person who stutters, are greater than the brain’s capacity to produce that fluent speech, so a breakdown in fluency occurs. Some would argue, that when the anxiety level reaches a certain point, the person who stutters goes into a level of, “fight or flight” response. In doing so, the body prepares itself to fight or flee, and resources for fluent speech are not high on the bodies agenda in this state. John Harrison, in his book “Redefining Stuttering” talks about what he calls, “approach avoidance conflict”, where part of the self, (the adult part), wants to approach the speaking situation, while another part of the self, (the child part), wants to avoid it. With one part of the self wanting to go forward, and the other part wanting to retreat, the result is a stand still, which manifests in a speech block. Bob Bodenhamer, in his book, “Mastering Blocking and Stuttering”, refers to the anxiety of a person who stutters, manifesting in the muscles used to produce speech. No matter what the reason is, it is clear that for most people who block and stutter, the degree of stuttering is generally increased as their anxiety level increases.

What we need to understand, is that our anxiety level is self created to some extent. It is a, “do-it-yourself job”. An, “inside job”, if you like. It is as a result of our subconscious determinations of probability and consequence, combined with our innate general level of arousal. Having said all that, our responses to stimuli, that lead to our determination of probability and consequence, tends to come as a “reflex reaction”, as a result of past experience, but we can learn to override those “hard wired” reflex reactions.

As people who stutter, how can we take control of our reactions? We can do this by challenging these reflex thoughts and feelings, that have been, “programmed”, into our psyche, from our past beliefs, and our own assessment of reality, and “the way the world is”. This programming, has mainly come from our childhood, where were accept the world as we see it, rather than question if the beliefs that we are building about the world, and our place in it, are going to be resourceful to us as an adult or not. We can, and need to, begin to replace these perceptions of the world, with more resourceful analysis, by questioning these somewhat automatic responses to the stimulus before us. If we accept that our initial reflex assessment of the, “consequence” of our stuttering, might be flawed, we can begin to train ourselves to question this assessment.

As a person who stutters, we have invested a great deal of time in developing the ability to, “mind read”. What I mean by this is that, while we are in the process of speaking, we are attempting to assess what the listener is thinking about us, in terms of what we are saying, how we are saying it, our level of intelligence, and generally, our validity as a person. Brain studies have shown activity in parts of the brain of a person who is stuttering, that is not normally active in a fluent speaker while they are speaking. Could this activity be related to this secondary, “mind reading” program, that is running while we are trying to speak? It is understandable, that it would be difficult to speak, and think about what we are wanting to say, while we are trying to assess what the other person is thinking about us, and what the consequences of that might be to us. Not only are we concerned about the primary listener’s response, but also the secondary listeners response. By secondary listener I mean the people around us, not directly involved in the conversation, who are hearing us speak. How often are you just as concerned about what others, who are hearing you speak, are thinking, and what you perceive the consequences of their thought might be.

As mentioned in my last post, people who stutter or stammer appear to have a lowered capacity to manage the speech mechanism, when their fear of speaking anxiety level goes above a certain threshold level. If we realise and accept that, we can start to look at what are the components that determine our level of speaking anxiety. Well I am going to let you in on a little known secret about the components that make up your speaking anxiety level, as a person who stutters or stammers, and what you can do to reduce your anxiety surrounding stuttering or stammering.

There are two main components that contribute towards your speaking anxiety level, and your subconscious brain knows this, even if your conscious brain does not. In any situation where you have to speak, your brain does a quick “calculation” that basically will determine how anxious you become about that speaking situation. In simple terms, it takes each component, and gives it a rating out of 10, then multiplies the two ratings together, and that gives you an anxiety index level as a rating out of 100. Now this all happens in a fraction of a second without you knowing it.

So what are these two components that the brain considers in determining how anxious you are in any speaking situation. Well the first component is:

Probability.

Your subconscious brain asks itself this question. “What is the, probability, of me blocking or stuttering in this situation”? As mentioned above, the answer is effectively expressed in terms of a score out of 10. So if you “believe” for one reason or another that you will be totally fluent, then your brain gives that a score of 0. If you believe there is a bit of a chance that you will stutter, then your brain might give it a rating of 2 or 3. If however the assessment is that you are very likely to stutter, then a 7, 8 or 9 might be the rating. Now where does this assessed rating come from? Well, it is an accumulation of all your experiences of speaking to different people in different situations, and the older you get, the more of a reflex this subconscious calculation becomes.

The second of the two components is:

Consequence.

Your subconscious brain asks itself this question. “What will be the, consequence, of me stuttering in this situation”. Once again the answer is effectively expressed in terms of a rating out of 10. So if you believe for one reason or another, that it really does not matter if you block and stutter, and there will be no consequence at all, then your brain gives that a rating of 0. If there are some concerns about what the impact that your blocking and stuttering may have in some way, then the score starts to climb the scale to a 2, 3 or maybe a 4. Now if your assessment of the consequences of stuttering are such that you believe it is likely to be, catastrophic to you in some way, then the score can reach a 9 or even a 10. Ratings of 9 and 10 would have to fall into the category of a panic attack, and many people who stutter would know exactly what I am talking about here.

So let us say that your subconscious brain assesses the, Probability, of you stuttering as being a 4, and it assesses the, Consequence, of you stuttering as being a 2. The total rating the brain has assessed is an 8. That is a speaking anxiety index level of 8, out of a possible 100. Now if the speaking anxiety level where stuttering is likely to be triggered in is say, 20, then you are unlikely to stutter or speak with a level of dysfluency that is greatly noticeable to you. That is not to say that there will be no stuttering. It is just that it is likely to be of a level that is inconsequential or unnoticeable to you, and is basically a result of habit rather than dysfluency caused by anxiety and fear.

If on the other hand, your subconscious brain assesses the, Probability, of you stuttering as being a 9, and it assesses the, Consequence, of you stuttering as being a 5, the rating your brain has assessed, is 45. That is a speaking anxiety index level of 45, out of a possible 100. Once again, if  your speaking anxiety level where stuttering is likely be triggered is 20, and your brain has the body at an anxiety index factor of 45, then a high level of stuttering will be evidenced, even though your concern about the speech dysfluency is only moderate.

Now, I do not want to complicate this any more than is necessasry in order to give you an understanding of the components that are making up your level of anxiety, but there is a third component that is related to Probability, and that is, Degree. By degree, I mean that a person who stutters my have a level of variability in the degree of their blocking or stuttering. Degree is also closely related to the anxiety rating in that the higher the anxiety rating, the higher the degree of dysfluency. This is a complex component because it is circular to some extent, in that a greater degree of stuttering can lead to a higher “consequence” score, and therefore a higher anxiety index rating. For the purposes of this post, we will ignore, degree, as a component in understanding anxiety.

So why is it important to understand these two main components that make up your anxiety level? Well for those of you who are mathematically inclined, you will have already realised that if you want to bring down your “anxiety index level”, then you can begin to eliminate a lot of the problem, if you agrees that a lot of your fluency problem is related to your anxiety level.

It is clear then, to bring down the anxiety level, you have to find ways of reducing the probability of speaking dysfluently and/or reducing the consequence of such speech dysfleuncy.

In previous posts we have spoken, in broad terms, about the options that are available to facilitate a person in the process of reducing the, “probability of stuttering”, to a degree that it is not a concern, however, we will assume that the person is unable for one reason or another to reduce the probability of dysfluent speech, or that, even though their physical stuttering has been reduced, or even eliminated, they are still concerned about the consequences of blocking or stuttering, if it was to occur . We must then begin to work on reducing the consequence of speech dysfluency, and this will be the topic of my next blog post, so in that regard I once again invite you to subscribe to my RSS feed, or my email notification, so that you do not miss my next post, where we will talk extensively about how to reduce the consequences of blocking and stuttering. Finally, I urge you to make a comment on what I have outlined here. Thank you.

In my last post, I spoke about the two main general approaches that make up speech therapy for stuttering/stammering. Those approaches, being the fluency shaping method and the stuttering modification method, also known as “stutter more fluently”. I concluded by mentioning the fact that, irrespective of which form of speaking modification method is used to reduce the physical symptoms of stuttering/stammering, one cannot gain total fluency or anything approaching it, unless one realizes, that the key to real progress, lies in the intervention on the psychological side.

Research into the cause of stuttering, over the last decade or so, has confirmed that there are definite anomalies, within the brain of a person who stutters, that are a major factor in identifying the cause of stuttering, however, it is a little understood fact that we are capable of “rewiring” or “circumventing” those faulty parts of the brain, so that the symptoms of stuttering can be reduced, and quite substantially.

When I say that the symptoms of stuttering can be reduced, we immediately think of the physical action of stuttering, which includes, speech repetitions, prolongations and cessations of sound or blocks, as well as the secondary behaviour associated with the struggle to get the words out fluently. However, as was the subject of my post on the Stuttering Jack Scale of assessing the severity of stuttering, there are other less obvious symptoms of stuttering that need to be considered when talking about the symptoms and degree of stuttering. I am of course referring to the psychological symptoms which include fear, shame, anger, guilt, confusion and lack of clear thought, anxiety and panic, frustration, embarrassment, isolation and social phobia etc. It is common for a person who stutters to be fearful of the judgement of others towards their dysfluent speech. If the individual perceives the situation in a very negative way, he or she can develop a high level of anxiety about the prospect of stuttering. This can even approach feelings of panic at being “out of control”. As a result, one can become confused about topics which are normally easy for them to talk about. Some people describe this situation as “greying out”, as the mind tends to go blank when trying to verbalise an answer while stuttering. Stuttering and/or the fear of stuttering can lead to a degree of social phobia, and studies have shown that a high percentage of adults who stutter demonstrate the symptoms of social phobia.

Most people who do not stutter, would have experienced varying degrees of anxiety if and when they have been called on to make a speech in front of an unfamiliar group without being prepared. As thoughts flood the brain about how others will judge them, and what that means to the individual, the mind can go blank, and speech can become dysfluent in the most eloquent of people, especially if confusion and time pressure are added to the equation. Some people who stutter, can also feel emotions that can cause embarrassment, and anger over the situation that they find themselves in. As a result, some individuals can choose to isolate themselves to varying degrees from people who they have trouble speaking to, and avoid situations that they tend to stutter more frequently in, hence, leading to the varying levels of social phobia, referred to above. So there are really, as mentioned, two strains of symptom that make up the disorder, known as stuttering, and these two symptoms can vary from person to person, situation to situation, and also vary in degree from day to day.

While the physical symptom of stuttering is extremely frustrating for the person who stutters, the majority of people who stutter would confess that it is the psychological impact on them that is by far the hardest symptom to live with. Now if that is the bad news, I also want to tell you why it is reason to also be the good news.

Why it is the good news is that while it may often be a long, costly and complex process to directly alter the physical symptoms of stuttering, which as we have said are to do with neurological anomalies in the brain, it is possible for the person who stutters to alter how he or she reacts to the thoughts and feelings that trigger the blocking and stuttering, and even better, the individual is able to change the thoughts about the stuttering experience, and as a result alter the reaction to it to be more resourceful rather than destructive.

Our thoughts about a stimulus or stuttering trigger, be it a person or a situation, are what gives rise to anxiety and once our anxiety reaches a certain level the stuttering will appear. Having said that, anxiety is not a prerequisite for stuttering but it certainly aggravates the problem. What is a prerequisite for stuttering is the programming of our belief system and the programming of the stuttered speech habit that has become hardwired into the brain at an early age.

It is interesting to note that every person who stutters tends to stutter in their own way, and it has even been said that the physical act of blocking is actually an effort to try not to stutter. It is a manifestation of the effort to try to get the word out. It is also interesting to note that the individual’s way of stuttering is never forgotten or removed from the brain, and in cases where an individual has been successfully treated using a fluency shaping method, and does not stutter for many years, if the stuttering returns it does not return in a different way but the exact same way that was peculiar to the individual before being successfully treated, many years before.

As mentioned, the belief system plays a major part in the degree of stuttering that a person will exhibit at any one time. In that regard it can be argued that where a person is fluent in one situation, and not fluent in the next, it is as a result of the actions of the belief system, in that to trigger the stuttering one must first think about stuttering, which then triggers the belief that one will stutter. This then in turn triggers the brain to look for words that it believes will require extra effort to get out. This then triggers what, Bill Parry, calls a “stuttering valsalva manoeuvre”, where the body, through the respiratory system, tries really hard to get the word out and consequently gets caught up in what John Harrison calls a “stuttering approach avoidance conflict”, and the result of all this is a speech block. Now that is all getting a bit complex at this point in time but as you can see, to successfully treat both the physical and psychological symptoms of stuttering, one needs to understand what is going on.

At this point we will leave the complexity of treating the physical symptoms and continue to concentrate on how we can control the anxiety associated with stuttering. In my next blog post I will reveal some little understood secrets of what contributes to our levels of stuttering associated anxiety, and, give you some tips on how to reduce that anxiety. So in that regard I once again invite you to subscribe to my RSS feed or email notification so that you don’t miss the coming blog posts where I will begin to reveal how I have been able to successfully turn a “5,5 stuttering problem”, into “0,0 stuttering freedom and speaking confidence euphoria”.