This is a threaded discussion page for the International Stuttering 
Awareness Day Online Conference paper, What Is Wrong With John 
Wayne's Stuttering Therapy? by Hans-Georg Bosshardt (Germany). 

Humanistic Side of Treatment
From: Ellen Bennett
Date: 10/1/98
Time: 3:53:05 PM
Remote Name: 129.108.2.198
Comments
What a wonderful job of pointing out the need to looking at the 
humanistic side of treatment for people who stutter. JW's treatment 
style, though effective at that moment, can have a back-lash effect 
on the client. I encourage Speech Language Pathologists to consider 
the personal side of the client when developing treatment plans. 
SLP's should ask them selves "Would I be able to do this task?" or 
"How would I feel if I had to do this task?" Shocking the client into 
being fluent versus assisting the client to discover how to be fluent 
may have different long-term effects on the psyche of the client. 
Certainly is something to think about.

Clinic room therapy
From: Ed Feuer
Date: 10/1/98
Time: 4:06:36 PM
Remote Name: 207.161.63.109
Comments
What John Wayne did is really not too different from the approach of 
those clinicians who get their stuttering clients relaxed in the clinic 
room where they control all the these clients relaxed in the clinic 
room where they control all the variables and there is only one focus. 
They give the stuttering client some “techniques” and voila — they 
are temporarily "fluent" or there are less "moments of stuttering." 
"Now," says the clinician. "Just go out and use the techniques." 
Invariably the person who stutters falls flat on his/her face in the 
real world, and if he or she comes back to the clinician they are told: 
"Ah, you're just not working." Saddle up, pardners.

Re: Clinic room therapy
From: 
Date: 10/19/98
Time: 1:17:51 PM
Remote Name: 209.18.244.27
Comments
This is a good point. The "Try & Can" approach can easily infiltrate 
those who should know better.It was interesting that
swearing was the venue for fluency. While this can be a fluency 
enhancer for some (did John Wayne know this?) the tense
emotional conditions under which those words were spoken would 
tend (I'd think) to prevent fluent speech. I wonder how
those two seemingly opposite reactions interplay

So called "resistance" to therapy
From: Gunars K. Neiders, Ph.D.
Date: 10/2/98
Time: 5:34:42 PM
Remote Name: 199.238.253.15
Comments
Dr. Bosshardt, 
Thank you for making a good point. And, Ed, thank you for pointing 
out which therapists really have the John Wayne philosophy. 
Especially, those therapists that are unwilling to voluntarily stutter 
in the way the client does and yet ask him to go out and throw 
himself to the "dogs" without proper psychological preparation such 
as de-awulizing stuttering. 

Unfortunately a clients so-called "resistance" has been with us also in 
the field of psychology. There the "great" Freud invented the concept 
that some clients are resisting his good therapy. 

A more insidious type of JW therapy is the claim that a client is not 
overcoming his problem because he has some mysterious payoff over 
which he has some type of voluntary control. An example of this has 
been floating around on the stutt-x and stutt-l list servers, "I am just 
not ready to accept myself as a fluent speaker." 

Fragmented self
From: Ed Feuer
Date: 10/3/98
Time: 1:13:47 AM
Remote Name: 207.161.119.14
Comments
Further to what Gunars said about some SLPs saying their clients 
have the attitude: "I am just not ready to accept myself as a fluent 
speaker." This is a euphemism for the repugnant "secondary gains" 
idea. I think that problem is really that the clients don’t want to 
accept themselves as persons who stutters. One of the major 
difficulties in treating stuttering is that very transience of stuttering 
— a phenomenon that many SLPs don't really comprehend. We're 
walking around with a split — a fragmented self. We don't stutter or 
stutter a lot less when there is little or no communicative stress 
(Situation A). We stutter more when there is communicative stress 
(Situation B). We want to view ourselves as A. But many significant 
people in our world see us only as B. Many fluent speakers, too, talk 
about a perception gap between how others see them and how they 
see themselves. For PWS, that gap is often far wider and real 
compared to the fluent speaker's "gap." And it probably has a lot to 
do with the resistance and sabotage about which SLPs complain. 
Problem is, far too much of current stuttering therapy is only token 
therapy and doesn’t address the fragmented self issue, let alone deal 
with it. — Ed Feuer

Re: Psychodynamic functions of JW's approach
From: Hans-Georg
Date: 10/5/98
Time: 12:06:04 PM
Remote Name: 134.147.208.1
Comments
I like to comment shortly on Ed Feuer's and Gunnars Neiders the 
interesting remarks. They both focus on the psychodynamic role 
which interpretational schemes can have for the therapist himself. It 
is worth noting that before therapy no professional will buy JW's 
approach but I completely aggree with their suspicion that after 
nonsuccessful therapy for some therapists the situation is very 
different. One way to cope with the own disappointment at a failure 
is to blame the client instead of the own therapeutic skills. 
"Resistance" of the client is a similar interpretational scheme which 
can be used by the therapist to maintain a high self-evaluation in 
spite of a failure. I know of only one cure against this: continuous 
self-reflection and self-evaluation of the own therapeutical process 
and supervision. Thank you for having made these interesting points. 
Hans-Georg

Re: Psychodynamic functions of JW's approach
From: Gunars
Date: 10/5/98
Time: 7:28:32 PM
Remote Name: 199.238.253.11
Comments
Another way for the therapists is to understand that they are fallible 
people with as yet incomplete understanding of the problem of 
stuttering. If the therapists truly adapt a view that they are entitled 
to make mistakes, as well as fail in the therapy process, without 
downing themselves as bad therapists or bad people, maybe they 
would not need to act defensively. Gunars

Psychodynamic functions of JW's approach
From: Hans-Georg Bosshardt
Date: 10/6/98
Time: 1:02:03 AM
Remote Name: 134.147.208.1
Comments
Ed Feuer and Gunnars made very interesting comments focussing on 
the psychodynamic role which interpretational schemes can have for 
the therapist himself. It is worth noting that before therapy no 
professional will buy JW's approach but I completely aggree with 
their suspicion that after nonsuccessful therapy for some therapists 
the situation is very different. One way to cope with the own 
disappointment at a failure is to blame the client instead of the own 
therapeutic skills. "Resistance" of the client is a similar 
interpretational scheme which can be used by the therapist to 
maintain a high self-evaluation in spite of a failure. I know of only 
one cure against this: continuous self-reflection and self-evaluation 
of the own therapeutical process and supervision. Thank you for 
having made these interesting points. Hans-Georg

JW therapy
From: Chuck Goldman
Date: 10/9/98
Time: 5:02:36 PM
Remote Name: 152.163.205.59
Comments
The JW stuttering philosophy is akin to the old notion that stuttering 
is in the stutterer's control. Although most leading research 
acknowledges that stuttering is not in control of the stutterer ( In 
fact voluntary loss of control is at the heart of the Perkins definition), 
the JW therapy approaches persist to some degree and with some 
reason. Stutterers must simply believe that they can control fluency 
to some degree in order for any therapy program to be successful.

Re: JW therapy
From: Hans-Georg Bosshardt
Date: 10/16/98
Time: 2:13:31 AM
Remote Name: 134.147.208.1
Comments
Dear Dr. Goldman: I aggree with you that the belief in the 
effectiveness of therapy and in the own ability to speak fluently is 
essential for therapy. But it is essential for therapy motivation and 
for the maintenance of this motivation in spite of relapses. Therapy 
with adults who stutter can be - and often is - a time consuming 
enterprise for which clients and therapists need to be highly 
motivated and must be able to maintain their motivation over some 
time. However therapy effect studies clearly show that there are 
therapies available which do not only influence the beliefs but which 
in addition have solid effects on speech fluency. In my article I 
wanted to stress that the inability for fluent speech has to be taken 
serious and I wanted to make clear how harmful the consequences of 
JW's behavior most probably will be. But I wanted also to stress that 
every "cannot" depends on the present demands and abilities. Both 
components are no "natural constants" but can be changed and 
therefore today's "cannot" must not necessarily be next year's 
"cannot". Personal motivation and belief in success are of course the 
essential forces which drive such a change. Thank you very much for 
your comment and for providing the opportunity to explain this in 
greater detail. Hans-Georg Bosshardt 

Loss of voluntary control, direct and indirect
From: Gunars K. Neiders, Ph.D.
Date: 10/19/98
Time: 6:31:32 PM
Remote Name: 12.13.226.11
Comments
In constructing Rational Emotive Behavior Therapy for stuttering, I 
am wrestling with the concept of voluntary control. Voluntary 
control is a slippery concept that can not be readily understood (at 
least not by me :-) ). To make things more confounding is that even 
the non-stuttering normal dysfluencies encountered by a normal 
speaker from time to time are NOT under voluntary control. When 
building up a client's confidence in the success of the therapy I posit 
we let the client know that two types of indirect voluntary control 
are available to all of us. Even though strictly speaking this control is 
voluntary it is displaced along the time axis. The after fact control 
was clearly demonstrated by Van Riper and his pullouts. The pre-
pullout was a try at voluntary control started after the client 
anticipated a stuttering incident, but before he started to talk. The 
easy onset also at times are used by the clients to voluntary control 
stuttering by acting before the onset of the block. The second type of 
indirect voluntary control is the statistical control via desensitization 
and de-awfulizing stuttering using cognitive psychology methods 
such as REBT. These are not perfect controls. The pullouts and pre-
pullouts, when done correctly would, even though starting with 
imperfect control, be extended until the feeling of control is 
established. 

My question then is: Could not a therapist convey to the client that 
voluntary control is not a Boolean variable (i.e. having the values of 
only yes and no) but a concept from "fuzzy logic" where control is 
both a function of time and probability that can be enhanced with 
work done a priori?

Re: JW therapy
From: Hans-Georg Bosshardt
Date: 10/16/98
Time: 2:13:43 AM
Remote Name: 134.147.208.1
Comments
Dear Dr. Goldman: I aggree with you that the belief in the 
effectiveness of therapy and in the own ability to speak fluently is 
essential for therapy. But it is essential for therapy motivation and 
for the maintenance of this motivation in spite of relapses. Therapy 
with adults who stutter can be - and often is - a time consuming 
enterprise for which clients and therapists need to be highly 
motivated and must be able to maintain their motivation over some 
time. However therapy effect studies clearly show that there are 
therapies available which do not only influence the beliefs but which 
in addition have solid effects on speech fluency. In my article I 
wanted to stress that the inability for fluent speech has to be taken 
serious and I wanted to make clear how harmful the consequences of 
JW's behavior most probably will be. But I wanted also to stress that 
every "cannot" depends on the present demands and abilities. Both 
components are no "natural constants" but can be changed and 
therefore today's "cannot" must not necessarily be next year's 
"cannot". Personal motivation and belief in success are of course the 
essential forces which drive such a change. Thank you very much for 
your comment and for providing the opportunity to explain this in 
greater detail. Hans-Georg Bosshardt 

Window Analogy
From: Valerie Johnston
Date: 10/14/98
Time: 8:57:10 PM
Remote Name: 209.30.10.182
Comments

I thought your analogy of the fragility of glass in a window as 
compared to the disablities behind disfluent speech was a good one. 
It is a comparison that I plan to use with the parents of children who 
stutter that I work with to explain how the environmental factors 
interact with the personal factors. Thank you for the insight. 

Valerie Johnston

Re: Window Analogy
From: Hans-Georg Bosshardt
Date: 10/23/98
Time: 10:06:51 AM
Remote Name: 134.29.30.79
Comments
Dear Valerie Johnston: I am really delighted that this image is helpful 
for your work. It was originally invented by philosophers to make 
their highly abstract "dispositional concepts" more concrete. Thank 
you very much for your comment. Hans-Georg Bosshardt