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From: Darrell Dodge
Date: 14 Oct 2004
Time: 01:32:22 -0500
Remote Name: 205.188.116.80
Thanks for your questions, Vasu. I'm sympathetic with your distrust of fluency shaping. But I wonder if you've really experienced the type of fluency shaping therapy that's used in the so-called "integrated approach." I've rarely had a client with whom I've used FSI who has really been able to perform truly fluent, controlled speech gestures. This is even true of people who manage to speak "fluently" most of the time once they are comfortable in the clinic. I consider the speech that we use in FSI to be the target or replacement speech used in stuttering modifications. Therefore, it needs to be learned and used under a modicum of performance stress, implying that you're going to be doing it deliberately and experimenting with using fluency shaping techniques outside the clinic. For example, a person doing a pullout needs to be able to perform a gentle onset as they pull through an unvoiced consonant to the subsequent vowel. In order to do that, you've got to practice a lot of gentle onsets and learn what they actually feel like. If you don't use these outside the clinic, you're not going to be able to break through the fog of a bad block to perform one. And you have to trust that by opening your mouth a bit (in spite of the fear you're feeling), you're more likely to free the voice. The first posting I made on the Internet many years ago was to a well-known therapist who totally discounted my experience that, although I hadn't experienced a lot of success with pure fluency shaping, once I had experienced some stuttering modification therapy I found myself using techniques I had learned in a fluency shaping program 15 years before. I "violently agree" that sitting in a closet doing gentle onsets all day is not going to help very much in the real world without something else. That's the major point of our article. I guess I'm a bit concerned by your comments on fear reduction because that was also one of the points of our article. Desensitization involves fear reduction, after all, and these include the "therapeutic moments" to which we refer. I hope this clarifies things. Thanks again. - Darrell