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From: Tim Mackesey
Date: 10/2/03
Time: 9:15:16 PM
Remote Name: 68.211.53.6
Very thought provoking and parallel to many of my observations of how stuttering has developed within pws. Allow me to weave in and around PTSD.
Fact: People who stutter who have reached a certain age and severity can recall with vivid detail past stuttering experiences. They can see, hear, and feel these past memories. When asked to "re-associate" into them, they can isolate where in their body they have feelings about the experience (i.e., chest/anxiety). They will often feel the very same thing when anticipating stuttering. THis mirrors General Arousal Syndrome and the Fight or Flight repsonse.
A 56 year old physician who stutters once gave me a Steven Spielberg-worthy recall of a teacher telling him to "spit it out" in first grade, THat was about 50 years earlier! He described the room, named children who witnessed it, and imitated the teachers voice and facial expressions.
Going further and explaining exactly how these memories are stored and how to re-imprint them is clinically significant. Somatic memory. Recalling a memory and feeling it in your body. The amygdula stores all things of pleasure and pain.
Have you ever wondered how a phobia can be learned instantly? Psychologists call it "one trial learning." We are born with the fear of loud noises and the fear of falling. All the others we learn. One bad landing on a flight can create a phobia in some.
These time-line references are significant. How can a pws recal specific words and situations that they fear and create enough anxiety as to avoid? I used to be an expert at this. What is the positive intention of avoidance? What does it protect against? It is an attempt to prevent a similar experience (emotionally traumatic). I did not use the phone for about a decade. After several hang ups, mockings, etc. I decided I would rather avoid than have the possibility of experiencing that again. Being asked to call was like being asked to cut myself and go swimming in the water surrounding the Great Barrier Reef in Australia. I got leverage to change later.
Ed, I believe, posed "what if experts in PTSD were recruited to help SLPs in this area?"
Therapeutic processes for re-imprinting these experiences is alive and well. I do it 6 days a week. For example, refer to "Adventures in Timelining" by Hall and Bodenhamer; "Movie Mind" by L. Michael Hall. These are replete with step-by-step processes to help.
Adolescents- adults who stutter can generally list specific words, situations, or people they anticipate stuttering in/with. And, it is a real challenge to use speech targets when the anxiety is raging. Where did the anxiety come from? Past time-line references. What if the anxiety was gone?
This is a great area worthy of pursuit to complement any existing therapies. We know how people returning from intensive, residential programs battle relapse. They re-enter those "old spooky" speaking situations (know as "anchors" in NLP) and when the anxiety fires up, they are hard pressed to stay on target.
One thing I missed in this article are people who started stuttering only after a PTSD moment in adult life. I have worked with three adults who had NO history of suttering until age 22-38 and began stuttering after a hideous phyical assault or similar.
Cheers, TIm Mackesey