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From: Steve Hood
Date: 10/16/02
Time: 3:33:16 PM
Remote Name: 199.33.133.50
Hello again. I thought of a couple of things I wanted to add to my earlier post, and was not sure how to intert something into an earlier entry, so I am reposting my earlier reply, followed at the end by some additional ideas. *****************
Hi, Cynthia.. this is a reply to you, and also a reply to the follow-up by Judy Duchan and Judy Kuster.
AND PLEASE NOTE: I am referring in this post more to teens and adults who stutter, not to children. Clinicians who works exclusively with youngsters should not necessarily assume that the following ideas pertain to them.
First, with respect to your original post, let's just leave the notion of tough love aside for a while. I think we may have gone off on the wrong tangent with this theme. Same goes for shady practices.
Let me just say that it is the duty and the responsibility of clinicians to be willing and able to put themselves into the role of the PWS. Normally speaking clinicians must be able to do the things they ask their clients to do. Joe Sheehan said it this way: "normal speakers should not become therapists until they have first become stutterers," (page 282, from his Stuttering: Research and Therapy book. 1970.
Let's forget about tough love and shady practices for another minute. The teens and adults for whom stuttering has become a chronic problem associated with fear, expectancy, avoidance, and effort have a difficult job ahead, and must be prepared to face it openly and honestly. THIS WILL INVOLVE SOME RISK TAKING. The clincian who would have the honor and priveledge to serve as the guide on this journey had darn well become prepared to also take risks !! Indeed, the clinician should go first.
People often use Van Riper as the example of a ruthless "tough love clinican." I WOULD REMIND YOU THAT BEFORE VAN RIPER BECAME A CLINICINAN, HE WAS FIRST A CLIENT.
Let me give an example.
Bryng Bryngleson was one of Van Riper's therapists. At the 1957 ASHA Convention there was a panel on recovery from stuttering, and VR told the story of the time when he had been working, unsuccessfully, to be able to do some voluntary stuttering. Toward the end of an unsuccessful day, he bumped into Bryngleson, and Bryngleson asked Van to try it again, just one more time. VR said "no." VR said he was "at the end of his bag... he said he was too tired, and had run out of morale." Bryngleson said fine, and said he would go first. Bryngleson went into the store and ordered some of "Dills Best Pipe Cleaners." And Bryngleson, a normally fluent speaker, stuttered with extreme severity. !!!! WOW !! Van Riper credits this as one of his crucial experiences-- because he could observe Bryngleson, a normal speaker, engaging in all of these severe stuttering behaviors.
Cynthia !!! We normal speakers need to follow the role of Bryng Bryngleson.
Judy Duchan... You asked if Judy Kuster and I might like to reply, so here I do..... First, I am sorry if you have lived for 40 years with some shame and guilt for not having done that assignment, way back in your student days. Since your work ((I think)) has been most primarily in the area of child language, this may not be the end of the world, so please, don't beat yourself up unnecessarily. These kinds of things are probably outside the ropes with kid-language issues.
But with kids who stutter, we somtimes engage in MILD forms of desensitization... We might hurry and rush a child a bit, or look away and break eye-contact. We might do some very mild interrupting, or we might disagree. We might expose the child to some mild social pressure, some social display, etc....... We help the child to increase his basal level of tolerance for stress, and move the bar up an few notches.
And to Judy Kuster... As usual, Judy, you hit thenail on the head !!! Desensitiation **IS** an essential part of treatment. Maybe I don't understand what "tough love is." I do it in ways that are encouraging, supportive, approving, trusting, accepting, etc.
Judy and I were blessed to have had Lois Nelson as our instructor. And Judy may be correct that the assignment was easier for me than it might have been for her... But I remember it as being terribly, terribly difficult. I was filled with fear. I worried that it would not appear realistic. I postponed, looked for just the right clerm, and did tons and tone of things that might also have been done by a PWS.
I certainly did not learn about voluntary stuttering, or become desensitized, during those several experiences. I have been continuing this journey of understanding others, and self-understanding for myself, ever since.
To those of you reading this clinical exchange involving Judy D., Judy K. and Cynthia-- I would encourage you to read the papers on ISAD by Russ Hicks and Bob Quesal. If you can learn to voluntarily stutter realistically, you will have a taste of the kind of gift I think Russ is talking about...... and if you keep doing it, and learning from it, you will ginally "get it" in the sense that Bob Quesal is talking about.
I hope others who attempt to apply techniques of desensitization in ways that are compassionate, kind, and considerate will chime in here. **************************************
Additional comments----
So, part of what I am saying is that desensitization need not be totally negative, noxious, or unpleasant. It need not be "shady" and it need not be "tough love." And when clients knows the RATIONALE and ultimate purpose, most view the process as an important and necessary step.
Let me give a few quick personal examples:
1. I never thought of myself as an "alergic person" and as a kid growing up in Massachusetts, I got stung by about every insect, wasp, bee, hornet that ever existed. But then when I got stung on the ankle by a bunch of angry yellow jackets about ten years ago, I had a terrible alergic reaction and needed serious medical treatment. I went through allergy desensitization therapy and I hope it was successful. But just in case it wasn't, I try to remember to carry my "epipen kit" with me when I am outside in areas where I might get stung. Maybe the stings ten years ago carried a different poison; afterall, my childhood stings were in MA, and these were southern insects from NC.
2. I remember times when I was a "nervous wreck" prior to giving a speech or making a presentation in front of a large group... While taking a college course in public speaking, the instructor would put us in groups, and we were assigned the task of heckling each other. Gradually, it got to the point where the heckling was not so troublesome, and by the time all was said and done, none of us were particularly bothered by distractions from the audience.
3. But sometimes, the desired outcome is not achieved. For example, I will get nervous when a group of spectators are watching me try to sink a four foot putt.
I hope that others will comment on this important theme.