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From: Ed Feuer
Date: 10/8/02
Time: 1:22:35 PM
Remote Name: 142.161.128.92
You say that the patient's perceptions improve in line with the progress in treatment. This view has been called the onion approach — that once you peel away the layers of stuttering everything is okay.
However, given the nature of stuttering and its decades of maladaptive conditioning, things don't work that way. Practioners can try to reinvent the same wheel over and over again but unfortunately reality keeps returning.
John Harrison's analogy of the ring is appropriate: If you try to replace a one carat stone with a two carat stone but don't create a new setting for the larger stone, it will eventually pop out. Your personality, your total self, is the setting for the stone, so to speak, and your speech is analagous to the stone, itself. When people try to ONLY change their speech, but don't change the setting, the new speech pattern eventually "pops out" because it is unsupported.
As for my own ideas about treatment about which you asked, I call for a coordinated multidisciplinary team approach — something that has never been done. But it will happen if and when we become serious about the treatment of stuttering.