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From: Ryan Pollard
Date: 12 Oct 2012
Time: 19:39:59 -0500
Remote Name: 69.116.220.90
Very cogent comments, Mark, thanks for posting. Your framing of skills/techniques as essentially a means to “find a work-around for a neurological deficit” is spot on. If a PWS is going to speak fluently, I think you’re right that, in essence, they’ll be fighting their own brain every day. But, viewed another way, is the physical part of that really as difficult as it would seem? Here’s my reasoning: exercising any kind of control over one’s stuttering requires that a person interrupts the natural (i.e., habitual) tendency of their speech mechanism to falter. This is true whether you’re using fluency shaping skills to speak more fluently or stuttering modification skills to stutter more easily. Either way, you’re changing what your body (and brain) is used to doing—namely, stuttering in your old way. But learning how to physically change one’s speech or one’s stuttering is not very difficult for most people. In fact, intensive clinics are predicated on that fact. Most PWS can learn and become quite adept at the mechanics of the “work-around” very quickly. Relatedly, most PWS report being able to speak fluently without effort when they talk to themselves. To me, this indicates that whatever the neurological deficit(s) that underlies stuttering, it must be fairly subtle if it can be overridden so quickly (e.g., through conscious application of skills/techniques) or simply vanishes under certain conditions (e.g., while speaking alone). Problems with relapse usually don’t surface until the element of context is added back in. By context I mean the real world: living and communicating in society. It’s that added dimension that makes “conscious, voluntary control” so difficult to maintain for many clients. In my opinion, that’s why desensitization to minimize emotional reactions and cognitive restructuring to instill new ways of thinking are so crucial: they enable the client to better manage/not be so negatively affected by context. Sorry for going on like this but your feedback really got me thinking… thanks! :)