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From: Gunars K. Neiders
Date: 10/6/01
Time: 2:26:31 PM
Remote Name: 134.29.30.167
Woody:
Thanks for bringing the important topic of working on emotions to the attention of this conference. As Eugene Cooper observed chronic stuttering syndrome involves Affect (another term for emotions), Behavior (the stuttering and avoidance behaviors), and Cognitions(the beliefs and attitudes).
You have stated the dynamic of the evolution of the feelings very well. The only major feeling that you did not discuss is the feeling of hopelessness/helplessness. David Shapiro in his book talks about how after a number of people have tried to help an adult person who stutters, some of them even being or passing themselves as speech therapists, the adult client gets this feeling that changing their stuttering struggle is beyond their capabilities. They feel hopelessly helpless even when the therapist assures them that their stutter can be at least modified to be less handicapping. To counter this feeling of helplessness David Shapiro suggests that the client in his first session be exposed to some of the things he can do to alter how he stutters, so that the client gets the feeling that this therapist/client relationship may have hope. Also Charles Van Riper's suggestion that the new client be introduced to other clients who have successfully ameliorated their struggling stuttering has merit.
Another feeling that you did not mention is the feeling that some clients have about stuttering therapy assignments. They feel that stuttering therapy assignments just "too hard", that "I just can't do voluntary pseudo stuttering". This feeling can best be tackled via modeling and cognitive techniques. It is my opinion that any stuttering therapist who cannot do the desensitization exercises such as voluntary pseudo stuttering (i.e. repeating a syllable, elongating a vowel or sibilant) best first train himself to stand, to bear these rather onerous exercises, because they are so basic in overcoming fear of stuttering.
The final emotion, the fear of failure, often pops up with clients who are afraid to go all out and really try to change their struggling stuttering behaviors or emotions because they have bought into the concept of conditional self-esteem. Conditional self-esteem is accepting yourself or thinking yourself to be a good person, because you do something well, somebody significant likes you, you possess some physical or mental attributes or own some pretty neat objects. You might ask what is wrong with this type of self-esteem? Plenty! Because significant other persons might just stop liking you, your physical or mental attributes might disappear as, for example, when you age, and the moths and worms might eat your neat toys.:-) Moreover, you will develop and maintain a deep-seated fear of failure. You will never go all out to gain anything of value.
With conditional self-esteem you frequently generate self-esteem based on fluency. So when you are fluent in can lead to your being anxious which is the antithesis of fluent or flowing non struggling speech. How does one combat the fear of failure? By working on unconditionally accepting yourself instead of building conditional self-esteem. Also by going out and purposefully failing at things and observing that your intrinsic value does not change.:-)
In the second section of your paper you talk about "Treating Specific Emotional Reactions." I believe that a more effective and efficient way of treating these reactions is based on Rational Emotive Behavior Therapy (REBT). REBT is based on the hypothesis that activating events evoke cognitive processes, i.e. attitudes and beliefs (some of which are sub- or pre-conscious) which result in emotions and behaviors. Studies have shown that it is possible, with practice, for people to uncover their pre-conscious beliefs, modify them and, thus, change their emotions and behaviors. To really make the new cognitions and emotions part of the basic personality it is also necessary to carry out behavioral assignments, such as voluntary pseudo stuttering, which contradict the erstwhile emotion, in this instance, to wit, the fear of stuttering.
To get more information on REBT one can visit Wayne Frogatt's excellent "Brief Introduction to REBT" at http://www.rational.org.nz/prof/docs/intro-rebt.htm and the REBT founder's Albert Ellis' website at http://www.rebt.org . Also, I am putting finishing touches on "How I Use REBT to Manage My Stuttering", which will appear within ten days (I hope :-) ) on my website http://www.stuttering-therapy.com.
In conclusion, I want to posit the hypothesis that the Gestalt based techniques for handling emotions which you describe in your paper might well work better with the artistic, sensitive type of client and REBT might well work better with the practical, common sense, scientific thinker. However, I do not have any studies to back up my hypothesis. Nevertheless, the mature therapist would be well advised to take workshops in both techniques. The REBT workshops are advertised on www.rebt.org.
My question to you, Woody, is: Do you still present Gestalt workshops through the Birch Tree Foundation?
Gunars
p.s. Hope to see you in New Orleans at this year's ASHA conference.