by Joseph G. Agnello
from Ohio, USA

My relationships with Charles Van Riper were varied: client and therapist, student and mentor; and finally, mutual friends and colleagues. Collectively, these relationships spanned over 40 years. Our communications took the form of group therapy sessions, face-to-face and telephone conversations, and letters. The topics of these communications included stutter management, attitude revelations and adjustments, academic and professional issues, and everyday joys and concerns of human life.

I focus here on attitude revelations and adjustments that, under Van's direction, became a healthy and ongoing process. What follows are seven points that characterize my therapy with Van and the therapy that I now conduct. I will treat stutter management techniques, such as easy onset, in later discussion.

Recognition of the problem. For the first several months of therapy, I held onto the idea that my stutter problem was a 'condition'; a single problem with a single solution. One afternoon, I realized that stutter was a complex of problems that involved attitudes about others and myself; especially attitudes concerning the way I talked. Upset by this, I ran across the campus to find Van. I sat on an overturned pail in his office and, in tears, asked: "Stuttering isn't my problem, is it?" I'll never forget his response: "Now we can begin work."

Desensitization to one's own and other's reactions to stutter, and associated fallacies. I was at a low point in therapy, feeling that I had invested a lot of time and had nothing to show for it. One morning, I accompanied Van to a nearby town to address a community group. We stopped for coffee and donuts on the way. As we entered, I noticed a group of truckers in a booth, conversing and laughing. I was convinced that I was the object of their joke. As I stuttered my order, I was sure that I was entertaining the clerk, too. Then it was Van's turn to order. Somehow I managed to put my own humiliation aside and, as he stuttered his own order, I observed. I was amazed by the reactions of the truckers and the clerk. The truckers weren't the least bit interested in us, and the clerk patiently took Van's order, idly commenting that his brother stutters. This event was the catalyst for recognizing my problem, as I described above.

The process of change: role-playing, pseudo-stutter, fluent stutter and practicing controls. The experience that I had with Van at the coffee shop was my first positive experience with pseudo stutter. Prior to that event, I was easily discouraged by the fact that pseudo-stutter inevitably became 'real'; I would loose control of my speech and, at that point, role-playing would cease; I would chalk up another 'failure'. That positive experience as an observer was my first clue that nobody really cared about my aberrant speech; people were generally kind and gentle, and far more interested in what I had to say, not how I said it. Equally important, it provided insight into the process of change that I needed in order to ". . .begin work": change would never come about unless I was willing to experiment and practice with role-playing. I had to experience 'failure' in order to gain confidence in role-playing, and that would lead to control over my speech. For the first time, I could actually envision a morning that I could wake up and realize that stutter didn't have to be the primary issue of the day!

Cognitive validity, anxiety, tension and speech performance. Anxiety appears to contribute to stutter severity and sense of helplessness. Van thought of anxiety as a state of mind that had motivational properties. He used to pull me out of the hall and announce that we were going to give a lecture to the Psychology 104 class in abnormal behavior. This is when I could barely say my own name! Van would give me a few tips on what I might do with my speech just before we entered the classroom. For example, preface answers to questions with "Well, there are two answers. . ."; while I gave my first answer, I was supposed to figure out the second, and then pseudo-stutter on that answer. He would always present me with at least two pages of observations after the lecture. I never ceased to be amazed by this, and his observations eventually led me to think in terms of the positive things I could do to manage stutter. Anxiety became a signal to observe myself; a thinking process related to good performance.

Avoidance. Avoidance undermines positive change and keeps you in a 'stutter loop'. It may provide temporary relief from anxiety over certain situations but, over the long term, eliminates any motivation to do anything about it. One of my greatest fears was the job interview. Van knew this and, when "Hire the Handicapped" week came around one year, he seized the opportunity. I interviewed for about 40 jobs that week. Toward the last interviews, I was actually looking forward to them. It was yet another lesson that I could break out of the 'loop' of living life at the mercy of my fears.

Resistance to change and transference. When it comes to our own beliefs and attitudes, a natural tendency is to think that change is unlikely or even unwarranted; we rationalize our state as 'who we are' or 'how we feel'. Van's written observations of my communication behaviors not only led to change in how I perceived anxiety, but how I dealt with stutter management in general. He took notes, so I began to take notes; and, like any good scientist, I began to examine the variables (e.g. social, motor, psychological, situational) and their interactions. Eventually, I saw that certain variables were tied to outcomes of particular situations. This generated a tremendous sense of self-control; not only in terms of the links between behaviors and results, but in the sense of freedom to experiment with role-playing and take charge of my own learning and development.

Recovery from relapse and stabilizing behavior toward 'total recovery'. Van wasn't around for one of my major and most unexpected relapses. At the age of 65, I was about to marry again: enter the father-in-law, one of the most intimidating men I've ever met. Intelligent, accomplished in business, and imposing in presence and manner, he poses every quality that, years ago would have raised my defenses and sent me into a fit of stutter. The problem was that, my past wasn't so far behind; old feelings of inadequacy and automatic responses to those feelings came rushing back, and I felt helpless to control them. It was time to remind myself that learning and development is a lifelong process, and I was not without resources. I began to observe and experiment, and feelings of helplessness were eventually replaced by a renewed sense of self-control; particularly over some old memories that had been lurking in the recesses of my brain. Perhaps the most important thing to understand about relapse is that it will inevitably occur, and sometimes when least expected; however, a disciplined approach to stutter management, diligently practiced, will progressively shorten the time spent in recovery. (I plan to post a neat model that I think Van would have enjoyed. I call it Patterned Behaviors of Thought and Speech: Handling Relapse and Recovery.)

I will be answering any inquiries on these seven points or any other aspects of Van's and my therapy process. The reader is also referred to "Change: Potential Qualities Become Actualities" by Joseph Agnello and A Study Guide for Charles Van Riper's The Treatment of Stuttering by Darrell Dodge

September 20, 1999