While taking Judy Kuster's seminar on counseling people with communication disorders, I had the pleasure of reading Marty Jezer's book, Stuttering: A Life Bound Up in Words. I read the book as part of an assignment to explore the feelings and emotions that people who stutter experience. I was instantly captivated by the feelings and emotions Marty experienced as a person who stuttered and wanted to share excerpts from Marty's book that opened my eyes to potential areas of counseling that might need to be addressed when working with people who stutter.

One of these areas was avoidance. People who stutter may avoid sounds, words, people, or situations for fear that they will stutter. In his book, Marty shared with us numerous instances of avoidance.

"As a teenager living in White Plains, New York, I often bought train tickets to Hartsdale, New York because the "wh" sound in White always gave me trouble. There were no buses or taxis from the Hartsdale train station, as there were from the larger White Plains station, but walking four miles home was preferable to stuttering in front of the ticket seller in Grand Central Terminal" (p. 10).

"What had long kept me from becoming an activist was my trepidation over saying my name and address to an arresting officer and speaking up in court before a judge" (p. 161).

"When I met someone I liked, I usually found a way to get close to her. Sometimes it would take months of getting up my nerve to make the contact. Since I could (or would not) use the phone to call her, I had to make intricate logistical plans so as to run into her accidentally. This strategy involved a lot of research ­ I would investigate her behavior as if I were an undercover FBI man. I had to learn what her class schedule was, what she did after school, what time she usually got home, where and when she liked to shop, so that (what a surprise!) I could just happen to be there" (p. 122).

Another area Marty shared with us was the belief that stuttering had a negative impact on his employability. Marty had such beliefs about several careers he was interested in.

"I admire Ed Hoagland as a writer, and as a stutterer with courage. He went out in the world as a journalist and took the risk of talking to strangers, conducting interviews, getting people to tell him their stories. I couldn't see how I could ever take such risks. So I gave up on the idea of being a journalist"(p. 150).

"The employment agents were always courteous....We'd shake hands, and they'd tell me that I'd hear from them if there was a need for a follow-up interview. There never was. I always figured that after I left these agencies the interviewers threw my application into the wastebasket or, if they had to present evidence to the employer that they were actually interviewing prospects, said that, yes, they interviewed this kid who stuttered, and though he could write they didn't think he was employable. I really believed that. I went through the motions of job hunting with no confidence that I'd ever land a job" (p. 151).

A third area was denial. A person who stutters may deny the effect that stuttering has on their life. Marty eloquently described his experience with denial.

"By focusing on my strong points, that is, by figuring out what I knew I could do and then limiting myself to doing just that, I was able to ignore the constrictions I was placing on my life...So safe did I feel within my limited area of success that I saw no need to branch out and extend myself. I saw no need to deal with or improve my disfluent speech. Within the safe area I had constructed, I could convince myself that I was doing all right" (p. 82).

"Does stuttering bother me? For most of my life I would have answered this question with phony composure and practiced calm. I would flash my most ingratiating smile and swallow my lie. 'Nuh-nuh-nuh-nope!' People would then tell me how brave I was and how wonderful it was that I could have such a severe disability and not let it bother me. Did I bask in their compliment? Yup! Did I believe them? Nope. And once the glow of my deceit faded, the truth would kick in. I would then feel shamed, embarrassed, stupid, scared. Not only because of my stutter but also because of how easy it was for me to lie. The truthful answer was that my stuttering was the defining fact of my life. It was my shadow, a ghost, the darkness within" (p. 83).

A fourth area that Marty addressed was fear: fear of talking, fear of listener reactions, fear of being identified as a person who stutters, and so on. Marty shared with us some of his fears.

"Consider the verbal obstacles to a successful relationship....First, there is the challenge of introducing yourself to a stranger who doesn't know your darkest secret....And then asking for a date: many people in this situation fear rejection; stutterers, however, fear the asking. So worried are we about not stuttering when asking for the date that we don't have any worrying energy left to fret about the answer" (p. 118).

"I was apprehensive about having a child for fear that she would inherit my disposition to stutter. I also worried about my ability to perform all the parenting acts in which fluent speech seemed a requirement. How would I read to her? Help her with her homework? Explain to her the workings of the world? Have funny conversations? Impart my knowledge and values? Would my stuttering embarrass her with her friends? Would she ever want to have them over?" (p. 221).

A final, and interesting, area that Marty encountered was protecting his self-identity as a person who stutters. Some people who stutter may struggle in therapy simply because being a person who stutters is part of their identify. This is something Marty experienced.

"What was crazy, when I think about it now, was not the voluntary stuttering but my attitude toward it. It was I, rather than the VS technique, that was cockamamy. I preferred to stutter out of control with halting, tension-filled blocks...This absurd attitude had more to do with the power of my identity and pride than with my proclivity for stuttering. I knew who I was when I was stuttering; I didn't know who I was or who I'd be when I was stuttering voluntarily" (p. 76).

"Just as I'm uncomfortable in changing the style of my clothes, I'm unable to get out of my skin and imagine myself as a different personality...I believe that this has something to do with my stutter. I interpret any effort to get out of myself, even if only to be playful, as a rejection not only of what I am but of my stutter" (p. 120).

So, what can speech-language pathologists do to address these feelings and emotions people who stutter experience? Marty had an answer. He suggested that clinicians need to help people who stutter deal with their feelings about stuttering and use counseling strategies that help them explore their self-understanding and self-awareness of the problem. More specifically, Marty comprised a list of 'wants' for therapy (p. 181-183).

1. There would be no assumption that there is something psychologically wrong with me.

"I would be going for therapy, not to cure some deep-seated neurosis, but to obtain better self-awareness and to get a grip on the concrete stuttering-related problems affecting my life. I would expect my therapist to accept the personal goals I set for myself, accept the lifestyle I wanted to lead, and support the way I wanted to be in the world. (If my goals, in the therapist's view, were antisocial or self-destructive, I would want the therapist to guide me toward that conclusion rather than force me to accept arbitrary goals that were not of my choosing.)"

2. I would want my therapist to be aware of the very real obstacles that exist in society.

"As a stutterer, there are obstacles I face in society that are not of my own making. I would therefore want a therapist who is able to distinguish between subjective psychological perceptions and objective real-world conditions ­ and who would help me to distinguish the one from the other."

3. I would want my therapist to focus on the present, at least in therapy.

"Living in the present doesn't require dismissing your past or slighting the need to plan for the future. My living in the present means not worrying about a phone call or a speech I have to make tomorrow. It means living fully now so that I am calm and clearheaded when I'm called to face the problems of tomorrow."

4. I would want my therapist to insist that I'm responsible for my behavior.

"Stuttering may be a disability and an obstacle, but it's not an excuse. What I do with it and what I make of my life are within my power."

5. In the tradition of the psychologist Carl Rogers, I would want the therapy to be client-centered.

"The goals we pursue would be my goals as, with the help of the therapist, I define them."

6. Departing company with some proponents of humanist psychology, unbridled individualism would not be mistaken for self-actualization.

"To be self-actualized is to function effectively in the social community, to feel part of it, to care for it, and to be serious about civic responsibility. For people who stutter this goal involves overcoming the alienation that is often a consequence of a fear of speaking. Productive therapy helps people get in touch with themselves and also, I believe, in touch with the needs of their society."

The point of this information is not to suggest that all people who stutter experience the same feelings and emotions. Not all people who stutter will experience these feelings and some will experience feelings that were not included in this paper. David Luterman, well known for his work in counseling people with communication disorders, suggested that clinicians cannot take the emotions away, but only transform feelings into productive behavior (p. 116). Clinicians need to LISTEN to their clients and use opportunities to help their clients become better 'thinkers' about their problem in order to facilitate the process of change. Listening to Marty Jezer through the wisdom he shared in his book has taught me to listen to the unique experiences of my future clients and to use each experience as an opportunity for self-discovery and growth.

Jezer, M. (1997). Stuttering: A Life Bound Up in Words. Brattleboro, Vermont: Small Pond Press.

Luterman, D. (2008). Counseling Persons with Communication Disorders and Their Families. Austin, Texas: Pro-ed.

You can post Questions/comments about the above paper to the authors before October 22, 2009.