As mentioned in my previous post, I own a SpeechEasy device, and although I experienced the drawbacks that I explained in that post, it did work for me in significantly reducing my stuttering. So how was this happening? I had been told about the so called, “choral effect” explanation, but what was actually happening? Well when I put the SpeechEasy device in my ear, it was a very strange and new experience for me, and my brain. Because it was a very new experience, my focus was very much on what was happening in my ear, but it also seemed to confuse my brain a little. I have always felt that many of the speech therapy techniques that I have used over the years, have had one aspect in common, and that is that they all tended to have an element of distraction in them. I have always found that I cannot stutter unless I first think about stuttering. If stuttering and negative consequences associated with stuttering do not come into my mind, then I do not stutter. But if I begin to think about stuttering, my brain then begins to pick out words that are approaching in my speech, and once I lock onto those words, then a speech block is sure to follow on those words I tend to perform the way that I believe I will perform. If I think I will block and stutter, then I do, irrespective of how much work on my fluency shaping technique I have done. As mentioned, many of these techniques have an element of distraction to them, and this includes the operation of the SpeechEasy device, although it is not the sole reason for its effect, as it also promotes speech prolongation at first, which also helps adjust the timing process of speech production.

When I put the SpeechEasy in my ear, my brain seemed to be highly distracted by what it was having to deal with, so stuttering, and more particularly, focus on the words, did not really enter my mind while I had the device in. I believe my focus was drawn to the sounds I was making rather than the words I was saying. Focus on sounds, rather than words, to correct stuttering, is a little understood or appreciated phenomenon which I will talk about in a future post. Now this all seemed to go very smoothly for a long time, and I was convinced that I would never have to go back to using a fluency shaping method, and that the SpeechEasy was, “the answer”, to stuttering. I talked six of my friends into buying the SpeechEasy, after they tried mine, and experienced effortless fluency, but things began to change.

Slowly over a period, I started to notice that my stuttering was beginning to return, even when I was wearing the device, until finally after about three months, I had returned to by former level of severe stuttering, even while using the device. So why was this? Well I cannot be sure, but I think that my brain made some internal adjustments, to compensate for the delay, (about 70 milliseconds), in hearing myself speak. I no longer listened to my speech through the ear that housed the SpeechEasy device, but listened through the unaided ear, and pretty much ignored what was happening in the other ear. I was also beginning to focus on words again, and ignore the sound in my ear. I also had some trouble using my fluency shaping skills when I used the SpeechEasy. I found that I was no longer getting the effortless fluency, that I had been getting while wearing the device constantly over the prior 3 month period, and in fact sometimes my stuttering was worse.

So why had this happened? Well as mentioned, I figured that my problem was that my brain had learned to ignore the SpeechEasy effect, and instead of listening to myself through the Speech Easy when I spoke, I was now listening to my speech through the unaided ear. So what did I do? Well I did what any self-respecting obsessed seeker of fluency would do, and went out and got myself another SpeechEasy for the other ear. I was now wearing two SpeechEasy devices, one in each ear, at the same time. I referred to this setup, when I spoke to my friends about it, as I was “wearing two guns”. Well to say this was an experience is an understatement, and my hat is off to any person who has to where two hearing aids, in order to be able to hear. It was like having my head inside a stereo sound system, and if I was in a noisy restaurant, or noisy office situation it was hell. Speaking on the phone was also a bit of a challenge, especially when I got a bit of audio feedback going on, but it worked. With two SpeechEasy devices in at the same time I was fluent again, and I thought that this would fix my problem, of being able to hear myself speaking through the ear that had no altered auditory feedback.

As you can imagine, wearing two hearing aids on full volume with delayed auditory feedback, was not an easy way to get through the day, but when you are a severe stutterer, who needs to be fluent to function effectively in daily life, it was an acceptable price to pay at all levels. But the story is not a happy ending, because after about a month or two of wearing, “two guns”, the blocking and stuttering returned. I could not believe it. This was too much to bear. I had two SpeechEasy devices in on full volume on DAF with a tenth of a second delay, and blocking. Wow, what an experience that was.

So how could this have happened? Well once again, all I can say is that the brain is an amazing piece of apparatus. I can only think that it made the necessary adjustment, to negate the scrambling effect that the DAF is causing. I tried longer delays, FAF, switching between DAF and FAF, a combination of the two, but nothing would bring back the original positive effect on my fluency. I went back to wearing one Speech Easy, and really tried hard to focus on listening through the aided ear when I spoke, but I was never able to return to the original benefit, that I had received, when I had the device in for that first three months. Now the unusual thing was that all but one of my six friends, who had also purchased the devices, had found the same thing. Initially very beneficial, but then they stopped using the SpeechEasy. Some had stopped for reasons similar to myself, but the others had stopped because what they had to go through in wearing the device, did not outweigh the benefit that they felt they were getting, as far as improved fluency.

A few of us persevered, thinking that some improvement was better than none, but all of us ended up decided to shelf the SpeechEasy, and return to focusing on our fluency shaping skills instead. It then dawned on me that if our brains had learned to adapt to the SpeechEasy, then if we did not use it for a period, then when we put it back in, we would get the original effect again, but unfortunately after an absence of using the device for 6 months, and even 12 months, when we put the SpeechEasy back in our ear, we found that there was little to no benefit gained, from having it in.

So what does this mean for the SpeechEasy? Is it of no use, a scam and no-one should think of purchasing it? Well no. I believe it has its place. My friends and I had an alternative method of controlling our stuttering. We were able to return to persevering with those fluency shaping skills we had learned in therapy, and for me they work very well, but require a lot of work to maintain at a level where I am mostly fluent. However, for the person who has no such skills, I am sure that the SpeechEasy will reduce their stuttering, to some extent, and even over the longer period, as long as the person is prepared to put up with the issues that I outlined in my previous post, but that is a big ask for most. It is a matter of comparing the costs to the benefits, both in terms of dollars and what you have to put up with.

Now, having said all that, I believe that everyone should have a SpeechEasy, or similar device,  in their “toolbox” of tricks that we all have to get through life with a stutter, but being asked to pay US$4,500 or more for a device that is as hit and miss as this, is just opportunism at its best. Should these devices cost that sort of money? Certainly not. These devices are being priced as though they are a cure, and they are certainly far from that, contrary to how they are being marketed by the developer and some speech pathologists. Why does an “In the Ear” Speech Easy cost US$4,500 in the USA when they cost about $150 to make in China, where locals can buy them for about US$300. One might argue that the investors and researchers need to recover their investment into research and development, but hearing aid technology and the concept of DAF has been around for a long time, and with chip technology and the cost of programming being at an all time low, this argument does not wash.Like all technology, have they been reduced in price, no, so why not?  Hopefully those associated with the companies that manufacture and sell the device, and hold the US patents for the “idea”, as well as those associated with the university that supports them, will reduce the price to where it should be, so that people who stutter can buy one of these devices to tuck into their back pocket, without it costing them an arm and a leg.

In conclusion, I feel for the parents of children and adolescents who are told about these expensive DAF devices. They know little about the true nature of stuttering, and how the brain works, nor do they know anything about the success rate or otherwise of the SpeechEasy device. They want to help their child and feel pressured to purchase one of these devices, yet most cannot really afford it, and do not know if it will help their child in the long run. Similarly the child or adolescent who has had a SpeechEasy device purchased for them, feels great pressure to use it, and to speak fluently while using it. This can cause financial hardship in some families, feelings of guilt, embarrassment, anger and frustration if the results that were expected by all concerned, are not achieved, which is likely to be the case in the majority of instances.

If you are really wanting to try DAF, I recommend trying a much cheaper device, that works the same way as the Speech Easy, but costs much much less, and is much more versatile, in that it can be used in both ears instead of only one, is easier to adjust and can be resold if you decide not to use it. I will be writing about such a device in the near future but in the mean time if you want some information on it, email me at jack@stutteringjack.com. Having said everything above, I believe that every person who stutters should own a DAF device of some type, to keep in their back pocket, to be used when you are having a rough day and need something that will reduce your stuttering to some extent. Just don’t pay more than US$900 for it.

The SpeechEasy is a small “anti-stuttering” device that uses hearing aid technology to deliver Delayed Auditory Feedback (DAF), and, Frequency Altered Feedback (FAF), to a person who stutters. DAF and FAF have been found to reduce stuttering to varying degrees. The SpeechEasy technology is based on the phenomenon that when a person who stutters, speaks or reads in unison with another person, then they do not stutter in the majority of cases. This phenomenon is known as the “choral effect”. DAF plays the person’s own voice back to them, and they hear it with a slight delay, usually about one tenth of a second later. FAF alters the frequency of the feedback that the person hears. It can be set at a high frequency, where the person hears a higher pitch voice, or a low frequency, where the person hears a lower pitch voice in their ear.

In this two part post, I would like to tell you about my personal experience with the SpeechEasy device. In the first part, I would like to tell you about some of the general pros and cons of the device, and in the second part, I will tell you how it is working for me.

Although I have tried most stuttering treatment techniques, I have always preferred to use Prolonged Speech as my stuttering control method, and have always had great success with it, although it requires a lot of ongoing work and concentration, to maintain fluent speech. When I first used the Speech Easy, I found that I was able to obtain effortless fluency. Although I was using elements of my fluency shaping technique, I did not really have to use those techniques, to be fluent while I was wearing the SpeechEasy. All I had to do, was listen to the delayed feedback in my ear as I was speaking, and a good degree of fluency ensued, without a great deal of effort.

The SpeechEasy device that I was using, was what is called an, In The Ear device. It could not be seen from the front or the rear, but could be seen from the side, however, having said that, it was relatively low profile. As a result I did not have any concerns about wearing it. I also made everyone at work aware that I had this new device, so that I would not be concerned about what they might be thinking of me wearing what appeared to be a hearing aid.

I would insert the device into my ear in the morning as I left for work, and I would remove in when I walked back in the door at the end of the day, so I guess you would say that I, “did not leave home without it”, and used it constantly. The reason for this is that I had a high level of fluency when I was wearing it, and an unacceptable level of fluency when I took it off. So I guess what I am saying is, that I did not have a great deal of carry over fluency when I took the device off, as some people had told me I may get.

Although I was not totally fluent when wearing the SpeechEasy, I was not blocking greatly, and when I did block, it was only for a fraction of a second, then I was moving again. I felt liberated from stuttering, and liberated from the fluency shaping approach that I had constantly worked on for many years. I found that I was pretty much able to speak to anyone in any situation while I was wearing the device, and my freedom to move around in all speaking situations was expanded greatly. There were however, some drawbacks to using the device that I discovered, and although some of these drawbacks were significant, they did not outweigh the benefits that I gained from constantly using the device.

So what were these drawbacks, and how significant were they? Let me go through these one at a time:

Comfort – Although the SpeechEasy was custom fitted for my ear canal, I was glad to take it out at the end of the day, as it can be uncomfortable at times, but having said that, this was not a great problem.

Battery – Although the battery of the SpeechEasy lasts a very long time, the device does not give you a warning when the battery is about to expire. I often found myself in the middle of an important meeting or conversation when the battery would suddenly run out. This was very disconcerting when it first happened, and was a reason for an element of panic on one occasion, however, a quick battery change is not too difficult (if you carry a spare), as long as you have an In The Ear version of the device, and not a Completely in the Canal version, (see below).

Background Noise – By far the biggest drawback of the SpeechEasy is background noise. When the SpeechEasy device is inserted into the ear and turned on, many of the ancillary noises around you tend to be amplified. The clinking of knives and forks in a restaurant, or the roar of a car that passes you in the street, all are amplified. You can lower the volume if you are not about to speak, but when you are speaking to someone, while all these ancillary noises are happening around you, it can be very difficult sometimes to hear what the other person is saying. One notable situation where I found it almost impossible to hear what the other person was saying, was when I was in a crowded restaurant having breakfast with some strangers. I had the device in my left ear. I could hear what the person on my right was saying, but when the person on my left spoke, there was so much background noise of clinking plates and cutlery, that I was not able to hear what the person was saying, and because I was sitting at a large round table with the person next to me, I was not able to turn my right ear towards that person, to make the listening easier.

Constant Altered Feedback – The altered feedback on the device is voice activated, which means, when you are alone the device will not activate unless you speak, or a noise is made. Now this is great in a situation where you are say at home alone, or in your private office at work, but when you are in the company of another person, or in a crowded room, everything that you hear through the ear that has the device in it, will be heard in the altered auditory settings, that you have programmed into the device. That means that the other person will be heard in the slightly delayed setting that you have, which is not so bad, but if you have your device set to include frequency altered feedback (FAF), then everyone sounds like Darth Vader or Mickey Mouse, depending on the setting that you have chosen.

Obsessed Dependence – Unlike fluency shaping skills that you carry with you in your head, the SpeechEasy device is an object, and as such it can easily be forgotten or worse still, lost or broken. I had a friend of mine who was so attached to his device, that he had a mild panic attack one day when he realised when he got to work, that he had forgotten his device, and had to rush back home and get it before he could front work for the day. His round trip home and back to the office took him 45 mins. Another friend misplaced his device for a week, and as a result suffered extreme anxiety for that week.

Fragility – The SpeechEasy device is a very fragile piece of technology. If you accidentally drop it on the ground and step on it, it will shatter. If you shake it around excessively, the soldered connections inside can break. The battery can shift inside the battery compartment and stop the little battery compartment door from coming open. If you have to force the battery door open, you can break it, and the battery will not stay in the device. If any of these things happen, the device needs to be sent back to the manufacturer for repair, which can take 2 – 6 weeks, depending on where you live.

Tinnitus – I don’t know if this was just peculiar to me, but after wearing the device constantly for 3 months, I began to develop a slight level of tinnitus or ringing in the ear, which is still there to this day. Adverse to Speech Fluency Skills – Although I was told that my fluency using the device would be enhanced by combining it with my fluency shaping skills, I found that I had difficulty applying those skills, when I was using the device. My friends who also used the device, said that they found the same thing. This was not so bad when I was wearing the device, as I did not need to use my fluency shaping technique to a great degree to be fluent, but when I took it off, the fluency technique was not there for me, and I would begin to stutter with greater severity.

Volume Adjustment – As mentioned, I have an In The Ear (ITE) device, which can be seen quite easily by others that I am wearing a hearing aid. That did not bother me greatly, however, others choose to purchase a Completely In Canal (CIC) device, as it cannot be seen. On my device there is a little dial that allows me to switch it on and off. as well as adjust the volume. In addition, there is a little button that allows me to switch between one of two preset programs, like FAF/DAF or standard DAF. It is very handy to be able to make these adjustments without removing the device, however, if you have purchased a CIC device, you are not able to make any adjustments without removing it, which is not practical.

In Part 2 of this article, I will answer the questions on every bodies lips, which is, am I still using the SpeechEasy and, if so, has there been any deterioration in the effect of my fluency enhancement. 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.

Prolonged Speech – In previous posts, I have spoken a lot about the difficulties that people who stutter tend to face, when they are trying to learn and maintain a fluency shaping technique. I have also spoken extensively about the psychological and spiritual sides of approaching the problem. There are a number of mainstream approaches to treating the physical symptoms of stuttering, but one of the most effective approaches that has been developed, is generally known as the Prolonged Speech method. I would like to talk about this approach in the next couple of blog posts.

The Prolonged Speech method, is the basis of most fluency shaping treatment programs that are taught around the world these days in various forms. The name comes from the fact that in using this method, the person who stutters is initially taught to say words broken down into their syllables, and the utterance of these syllables is “prolonged” to varying degrees for certain reasons that I will talk about below.

Prolonged Speech is relatively easy to learn, but like most stuttering treatment methods, it can be difficult to transfer into the outside world, unless the individual has a solid grounding in using it in a clinical environment. The practitioner responsible for teaching the method to people who stutter, aims to replace the client’s faltering way of speaking, with a more smooth and controlled way of speaking where the client becomes more aware of all aspects of the speaking process. As such the technique is best and most effectively taught in an intensive course, and the most effective courses have been shown to have a duration of at least 3 weeks. It is a well know understanding in psychology, that it takes 21 days to change a habit, and although stuttering is more than a habit, this understanding is certainly not lost on the effective treatment of stuttering as a behaviour based phenomenon.

Approaches to the teaching of the Prolonged Speech method vary from clinic to clinic, but the most effective format is to have a highly trained psychologist or speech pathologist, to work with a group of no more than 6 adults who stutter. The group sits around a table, and while speaking in their new way, are constantly monitored and observed by the clinician to ensure that they are continuously and effectively using the various aspects of Prolonged Speech, in a perfect manner and at the speech rate set for the various speaking sessions. The first week of the intensive is taken up by the process of learning to use Prolonged Speech, and at the same time being highly aware of monitoring the process as speaking is taking place. In the early stage of the first week the client is taught to break words down into syllables and these syllables are uttered with exaggerated prolongations at the beginning. This prolongation rate gradually increases over the week until the client is speaking at what would be an acceptably normal rate or speed. Typically these daily sessions, in the first week, are 10 – 12 hours in length.  The second and third weeks of the intensive are used, to have the person who stutters, start to transfer the skills learned in the clinic, into the “outside of clinic” environment. In the second week speech “assignments” are standard assignments set by the clinic, like talking to strangers, using the telephone etc., while in the third week assignments are set by the individuals themselves taking into account where they have had specific difficulties in their daily life. e.g work, home, education environment etc. If the course has been conducted in the correct way by an experienced professional, the result is that all individuals are able to speak fluently in all “outside of clinic” situations at the end of the course, however, unfortunately this is not the result from all clinics purporting to conduct a prolonged speech intensive, but that is a subject to be covered in a subsequent post.

While the immediate post-treatment results from a well run Prolonged Speech intensive are very impressive, like any learned skill, the new method of speaking and associated speech monitoring needs to be constantly used. This can be a very demanding task for most people, when they are faced with pressure in the outside world, to speak faster and more spontaneously, with less focus on all the skills that make up the Prolonged Speech method. For this reason, success in maintaining the level of fluency, achieved during the intensive course, is best facilitated by joining a stuttering support group, where others who are also working on perfecting fluency, gained from the use of Prolonged Speech, are also members.

So what are the “skills” that make up the Prolonged Speech method of controlling stuttering? There are basically 9 parts to this method as follows:

1)     The pre-vocalisation out-breath.
2)     Gentle onsets.
3)     Continuous vocalisation.
4)     Control of tongue and lip movements.
5)     Prolongation of syllables.
6)     Regular controlled pausing.
7)     Interesting intonation.
8)     Good eye contact.
9)     Slow controlled in-breath.

1) The pre-vocalisation out-breath.
In simple terms, stuttering is caused by a locking of the vocal chords or vocal folds situated in the throat. When these folds are closed, air is not able to flow out to create speech. When stuttering occurs, these folds are closed. It is also a common occurrence that these folds are locked closed when speech is about to be initiated. In addition, a problem can occur when one is breathing in instead of out when the individual goes to start to speak. In order to speak, breath needs to be flowing out to first ensure that the vocal folds are open, and then to keep them open and vibrating during speech. The breath needs to continue to flow out while the person is speaking.

2) Gentle onsets.
When the breath is flowing out, the individual must then begin to vocalise sound, but with a gentle onset there is a slow and graduated transition from no sound and no audible speech, to audible speech. If the onset of speech utterance is not slow and gentle, it is possible that the articulators will lock up. It will assist the individual if the onset of all sentence or phrase beginnings is a gentle onset. It is akin to initiating movement of a manual motor vehicle where the clutch needs to be slowly released, for the vehicle to begin moving without a faltering and jerky start.

3) Continuous vocalisation.
When the breath is flowing out, and the vocal folds are vibrating, and speech is being created using the speech articulators (tongue & lips), it is imperative that the underlying vocalisation is continuous. By continuous, I mean that there are no breaks in continuity of sound from when speech commences to when the phrase or utterance finishes. Continuous vocalisation is achieved by the constant out-breath vibrating the vocal folds. You can experience continuous vocalisation by just saying “aaaahhhhhhhhh” for say 5 seconds. It is a continuous sound with no breaks. Continuous vocalisation is important while uttering a phrase or sentence because when sound stops, the vocal folds of a person who stutters are likely to lock closed again, creating a speech block. During the intensive, the clinician ensures that continuous vocalisation is achieved by discouraging the client from using any “uhms”, “ahs” or any other fillers, which are a sign that focus on continuous vocalisation, is not being monitored by the client.

4) Control of tongue and lip movements.
When a person who stutters has a speech block, it is often that the closing and locking of the vocal folds is facilitated by, or given leverage by, pushing the tongue hard against the top of the palette when making the t, d, n and l sounds. Similarly the closing and locking of the vocal folds is facilitated by, or given leverage by, pushing the lips hard together when making b, m and p sounds. As mentioned above, it is imperative that the breath continues to flow out during speech, and this can be facilitated if the person who stutters, is able to control the tongue in such a way that it does not actually touch the top of the mouth during speech, and similarly controlling the movement of the lips, so that they do not actually touch during speech when sounds that would normally require such touching are made.

5) Prolongation of syllables.
As the name implies, the Prolonged Speech technique for controlling stuttering, is given its name because the syllables that make up words, are prolonged when they are uttered. Syllables are prolonged for various reasons. Firstly the syllables are prolonged when this stuttering treatment method is being learned, so that the speech delivery is slowed down so that the various aspects of the method can be learned and mastered. Secondly the process of concentrating on prolonging syllables does certain things in the brain to take awareness while speaking, away from the listener or audience, and onto the processes being used to speak. Finally it has been shown that prolonging of the syllables, when a stuttering moment is encountered, can assist in getting the words out more fluently. As Prolonged Speech is being mastered the prolongation rate is gradually reduced so that speech gets faster, until it reaches the “normal” range of 180 – 200 syllables per minute.

6) Regular controlled pausing.
Breath control is critical for the person who stutters, to be able to control stuttering and produce free flowing stutter-free speech. When a person who stutters begins to utter a phrase or sentence, and what he/she wants to say is coming out fluently, there is a tendency for the person to continue to go on speaking as long as possible, without pausing to take another breath. While a logical reason for this behaviour can be argued, such behaviour can quickly lead to dysfluent speech. The reason for this is that the individual will eventually run out of breath, and the feeling of being out of breath, can trigger stuttering behaviour, like rushed breathing. It is recommended that the person who stutters speaks in shorter, rather than longer, breath lengths and preferably aims to speak in a constant rhythm of breathing, speaking and pausing. This will facilitate the control of the speaking process.

7) Interesting intonation.
When a person who stutters is using continuous vocalisation, combined with prolongation of syllables, there is an initial tendency for the person to develop a somewhat monotone and robotic sort of a sound. This is due to the underlying continuous vocalisation, being made on a limited range of intonation or voice melody. It is imperative that the person learning to master Prolonged Speech, learns to vary the intonation of the vocalisation, in such a way that it takes away any level of monotony in the sound of the speech delivery, and sounds as “normal” as possible.

8 ) Good eye contact.
Good eye contact with the person that one is speaking to, is a good trait for anyone to have, and no more so than for a person who stutters. People who stutter generally tend to look away from the listener, when they are in a stuttering situation. This makes it difficult for both the listener and the person who stutters. When the person who stutters looks away, the listener has a tendency to become embarrassed, and also wants to look away, while the person who stutters tends to lose his power and confidence in the speaking situation.

9) Slow controlled in-breath.
When a phrase or sentence has been uttered, and the vocalisation comes to a temporary halt, it will help to release all residual air in the lungs. At that point it is time to breathe air into the lungs, in order to prepare to start of new “cycle” of speech, for the next phrase or sentence to be uttered. While some stuttering control techniques teach that a fast and full breath should be taken, in this method the in-breath is slow and controlled, and should ideally take 1 – 2 seconds which facilitates the pause, and also formulation of the next phrase or sentence. We do not rush the breath in. At the top of the breath we do not begin to speak, as mentioned in point one above. We must start the whole cycle again, which is to begin by breathing a small amount of air out to open the vocal folds before the vocalisation commences again.

When a proficient exponent of the Prolonged Speech method is speaking, using this stuttering control method, he would be speaking more fluently than most “normal” speakers would be speaking, and the average listener would not be able to detect that he is speaking in any way other than a perfectly fluent normal speaker.

For Prolonged Speech to be effective in all situations, it needs to be used constantly, as it is more a technique to use to stop getting into stuttering behaviour rather than to get out of it. It is not for everyone, and most people other than severe and chronic stutterers, who are highly motivated to achieve total fluency, are unlikely in the long run to give up spontaneous speech, and to put the constant effort and awareness in that is required for this method to control stuttering in all situations. Having said that, it is still the best method available to treat the chronic stutterer and the highly motivated for whom the quest for fluent speech is not negotiable.

This describes the basics of Prolonged Speech. In the next post I will talk further about the more advanced aspects of ensuring that Prolonged Speech really gives the results that every person who stutters is seeking. 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.

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.

Some time ago, a stuttering teen reader of the Stuttering Brain blog, wrote this frank and open account, of her feelings about her stuttering problem. I quickly typed my thoughts down into a response to her seeking help for stuttering/stammering, which I now want to share with any other teen stutterer who may find these ideas helpful in coping with stuttering/stammering.

Sweet 16’s email

Yeah, I tried a self-help group, attended a stuttering conference, and tried stuttering therapy countless times. I also got an iSpeak SpeechEasy device. I seemed to have stopped stuttering 6 months ago, and it was the greatest days of my life, but then suddenly it came back, and it came back HARD. I can hardly speak a single word without stuttering, and I’ve had to give up countless times in the middle of a sentence I realized I can’t finish. I’m at the point where I would rather lose my voice permanently, so no one would expect me to talk, than to keep struggling and forcing myself to get through one single sentence, and the embarrassment that follows. I know I’m only 16 years old, but I have so much stress from life right now, and I so badly want to go to college and get my life-long dream job, (a computer repair technician- talking is a MAJORLY important part of the job). Life isn’t going to get better, its going to get worse, and there’s going to be more stress. I know there’s no cure. I’ve been told it countless times, and it runs through my head everyday. I know that Pagoclone or any other pills will NEVER, no matter how bad I want them to, take away my stuttering. But right now, my stuttering is so bad, that anything that will improve my speech by 20% will be a miracle to me. If you’ve been stuttering since you were little, too, then you would know what it feels like to think of your whole life ahead of you as hopeless, and a life that will mean nothing to the world. Even just enough voice to tell people what it feels like to stutter would be great. Sure, I could write a book, but I’m not a writer. I have no special abilities at all, and no good looks. That’s why I have to rely on my personality fully. I want to be the person who can accept their stuttering and make people laugh, (in a good way), but I can never see that happening. I can’t even see getting married. And I want to stand at the front of the church wearing a beautiful white dress and be able to at least say, “I do.”

P.S. I’m sorry for writing such a long message, but you’re a stutterer too, (I presume), and you may be the only person in the world who would understand, or in the least bit care. I could write a 50,000 page book on what it feels like to be a stutterer, and the probability of non-stutterers actually understanding it, or even reading it is so low that it’s pointless to waste my time writing it. I wish that some stutterers would just compile a book of how it feels to stutter, and make it interesting enough that people WOULD actually read it. Not laugh at it. I’d be willing, if I could find more people, and if my life was more interesting. Thank you for your blog, and your interest in helping people. I want to be like you and do the same.

Stuttering Jack’s response

I feel for you, and all of us who have severe speech blocking and associated high anxiety, know exactly how you feel at this difficult time in your life, where you have everything ahead of you. I believe that one day you, like some of us, will come to see your particular problem as a blessing rather than a curse. It will certainly shape your life, but you will be the architect of your existence, and you must learn to mould your life with the clay that you have been handed.

Firstly, what you must do is accept what is. You will never be able to change until you first deeply and completely accept the situation, and learn to fully love yourself as you are. Take full responsibility for your situation. You are not a victim to be washed around by the tides of life. It is within your power to change, and the answers for YOU are all out there to be discovered. You just have to seek them out, and it will be the journey, not the destination, that will nourish your soul. Love yourself and love everyone you speak to, as this alone will help wash away the fear of communicating with others.

Secondly, you must stop using negative affirmations and visualisations. These are powerful forces that are currently working against you rather than in your favour. Instead of negative affirmations like, “life isn’t going to get better, it is going to get worse”, “I know there is no cure”, “an improvement will be a miracle”, “whole life ahead of you is hopeless”, “a life that will mean nothing to the world” and visualisations like “I can never see that happening”, “I can’t even see getting married”, I want you to use positive affirmations and visualisations that create, in your mind, the pictures and images that you want to see, in your life, even if they seem such a distant dream to you, and keep them in the forefront of your mind, in big and bright colours. See yourself in that ideal picture, and feel what it would be like to live that dream. Do this every day and you will begin to move towards that, even if it seems so far away.

The most encouraging comment that you made, was that you recently did something to experience total fluency, for an extended period of time, then stuttering returned. Now that tells me, and should tell you, that there is a combination, (or number of combinations), that will unlock stuttering for you. You have found it once, now it is time to start your own little, “Sweet 16 research program”, to find a combination that is going to bring back what you have already shown yourself is possible. Who said stuttering cannot be cured? Stuttering can be cured, but it is an individual path for each person, that can be a short path or a long path. A cure for you may not be total fluency, and your cure may not be found down the same path, that others may choose to take, but you must believe that YOUR cure is achievable. It can be an easy path for some, or it can be an epic journey, but the longer the path to your own personal nirvana, the more you will find out about yourself, as an individual soul, and the more you will find out about life in general. Your cure may not be total fluency, it is more likely to be a level of acceptance, and a method of controlling your problem, but you will find YOUR answer, if you take responsibility for finding the answer and start your search now.

If you would like a few more tips to start you on your journey, here are a few:

1) Realise that you are more than your speech dysfluency. Look for the positive aspects of your nature, and continue to work on improving your non-speech gifts, and work on anything that can improve your confidence and self esteem.

2) Continually behave in as confident and self assured manner as you can.

3) Because the nature of your problem that you have described is, “more than just a tangled tongue”, and is in fact like a vine, that has wrapped itself around almost every aspect of your nature, you are going to have to approach your treatment, in a very systematic way, for it to have a reasonable chance of success. Here are the steps:

a) As mentioned above, acceptance of “what is” is a must.

b) Love yourself for who you are, including the stutter, is a must.

c) Before treatment, you must go out and learn to deliberately stutter. Not in the out of control blocking way that “happens to you”, but in a more relaxed, in control, repetitive way that you create. If the brain believes it has to create stuttering, learn to do it on your terms, not on the stutter’s terms. Stuttering used as a tool, is a completely different experience to the stuttering we are used to, that we feel we have no control over. When you deliberately be dysfluent, you are still, “in the moment”, and can function, where as with out of control stuttering, you are not, “in the moment”, and cannot, in many cases, think clearly. This is a big subject in itself that I cannot go into right now, but you must learn to stutter more fluently, as part of any stuttering treatment program, even if its goal is the eliminate your stuttering.

d) Following your learning and accepting of a controlled stuttering method, to help you when all else fails, you must learn methods to remove the emotions that you have built up in your body, associated with your stuttering. Learning EFT, (www.eftuniverse.com), will assist in this area if you want to give it a go. You must also learn to think correctly about the world, and your place in it, in order to try to control your stress and anxiety levels. For this I can recommend Bob Bodenhamer’s book, about a neuro-semantic approach to stuttering treatment. Once your thoughts and emotions have been treated, you are ready to learn to remove your physical speech dysfluency.

e) You need to be very selective in choosing a stuttering treatment program that is right for you. Unfortunately, at this point, no one has undertaken an exercise to easily do this for the different manifestations of stuttering, but it will eventually come, and I am working towards that myself. As learning to control your stuttering is basically a behavioural process, the longer and more intensive the process, the more effective and lasting I have found treatment to be for someone with the level of difficulty that you describe. I would be seeking out an extended intensive program, although the success you will have in one of these, will depend on the level of skill and experience of the clinician involved, and I cannot recommend anything for you here, so you will have to do your own enquiries or a bit of trial and error. Unfortunately the current trend is towards shorter treatment programs which, I believe, is not the way to go in treating the chronic and severe stutterer. Certainly weekly, 1 hour visits, to an SLP will not help what you are describing as the severity of your problem. Intensive courses are not cheap, but that is the level of financial commitment that you are going to have to invest, if you are to start out in a well equipped fashion, on your life journey towards freedom from stuttering. Don’t be discouraged, if one form of treatment has not worked for you in the past, especially if it was not taught in an intensive environment. Finally look for a treatment program that does not end when you walk out the clinic door, following initial treatment. Look for a program that realises that stuttering treatment is a staged process, and therefore offers ongoing retreatment and support at a reasonable cost.

f) What ever speech reshaping program you choose, realise that you will be fluent if you are “CONSCIOUSLY” “AWARE” of ALWAYS applying your learned skills, or you will eventually relapse. This is not true for all people seeking treatment, but once again, for your severity, this will be the level of commitment that you will probably need to apply. Now you will relapse anyway to some degree as we all do, that is for certain, but with each relapse comes a learning experience. A relapse is not a excuse to give up. I believe your journey towards fluency does not really start until you have your first relapse. Relapse is an opportunity to learn about you, and what you have to do to achieve your goals. For most people, a level of acceptance of stuttering is the best answer, as I have written about in my earlier blog postings, but if your goal is fluency, and all that comes from that, you will have to plan what you will do when you relapse.

g) The best relapse management tool is membership of a post treatment support group. You need to gather a list of people who are working with the same speech tools as you, and have the same fluency goals as you. When you relapse, you get together with these people for a day or two or longer, and you go through the process that your learned in your intensive program, and drill the skills back into your brain, and you go out and try again to make it last longer. As mentioned, this is not for everyone, but if you have a severe stutter and it works for you, then that is what you have to do.

h) When you are having success you must start to move outside your comfort zone, and use your ability to speak more fluently. That will also involve its own set of challenges, that I cannot go into here, but joining a Toastmasters or speaking group, has proven to help many people on our journey to achieving more consistent fluency skills.

By all means try Pagoclone when it comes out but as you said, at best, it is likely to make it easier for you to get through your blocks, not completely remove stuttering from your life. Whether that continues to have the same effect over time, or whether you need to keep increasing the dose, and whether you can afford the heavy weekly cost, only time will tell, but undoubtedly it will be where many people will choose to stop on their journey.

Your Speech Easy, as you have seen, works great out of the box, but our brains soon make the timing adjustment to get our stuttering back on track. To be fair, some people have continued to have success with DAF devices, so don’t write them off too quickly, as they are a great gadget to have in your, “box of tricks”, when you feel the need for something like that, I only wish that the distributors of these devices would sell them for under $1,000, which would still give them a profit.

Sweet 16, don’t let your stuttering control your life. You are the captain of your vessel, and you can take it in any direction you want to go, and even if you go through the stormiest of weather, there is always a calm harbour ahead of you, if you just keep moving forward. Many others have taken the same journey as you are now on, so make contact with these people and assure yourself that you are not alone.

Love,
Stuttering Jack

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.