About the presenter: George H. Shames, Ph.D. CCC/SLP, is Professor Emeritus after a 40 year career at the University of Pittsburgh where he was Director of their Speech Clinic, supervised practicum and was Director of the graduate program in Communication Disorders. He is an ASHA Fellow, a licensed Clinical Psychologist. He has authored books on stuttering, counseling, and speech pathology. His latest book is The Company of Truth, a novel about a young man who stutters. He developed a therapy for stuttering known as "Stutter-Free Speech," and has invented three FDA approved biofeedback devices.

You can post Questions/comments about the following paper to the author before October 22, 2006.


by George Shames
from Pennsylvania, USA

A year before I was born, Lee Travis published one of his earliest papers on the topic of Stuttering. When I was three years old Wendell Johnson published one of his earliest papers on stuttering. And when I was the ripe old age of eight, Charles Van Riper published one of his earliest papers on stuttering. How did I, as a toddler, get from there and then, to knowing and working with these three pioneers in the field of stuttering.

I have indeed been very fortunate to become a part of the culture of stuttering and to interact with its members. There have been so many more, young and old, whom I have gotten to know, whom I have worked with, and who have reached out and shared. People like Joe Sheehan, Dean Williams, Stan Ainsworth, Israel Goldiamond, Bill Perkins, Dick Curlee, Gene Brutten, Bruce Ryan, Mike Wingate, Bruce Flanagan, Oliver Bloodstein, Hugo Gregory, Gavin Andrews, Roger Ingham, Ed Leach, Cheri Florance, Al Murphy, Dick Martin, Gerry Siegel, Hal Luper, Peter Ramig, Barry Guitar, Richard Culatta, Stanley Goldberg, and Malcolm Fraser, to name only a few, were a part of my experience. It seems that I was in the right place, at the right time, with the right people. The names could go on and on, too numerous to list here, and I offer my apologies to those not mentioned.

I especially want to acknowledge the creativity of my students, and the sharing of those people who stutter that have worked with me. Each, over a period of many years, has contributed significantly to where I am today. I'm sure that many of you have had similar experiences with your students and colleagues. Such personal experiences , and many more professional experiences involve the people whose ideas and contributions you will encounter if you elect to involve yourself in helping people who stutter.

When I talk about the Culture of Stuttering it is first of all, THE PEOPLE that I am referring to; what the people give and receive, what THE PEOPLE bring with them and exchange,

The dictionary suggests that a cultural entity is made up of people who have in common and share such things as self-identity, ethnic background, race, religion, similar ideas, thoughts, values, superstitions, styles of life, language, nature of social interactions, geographic location, occupation, music, food, dancing, etc. The members often share styles of living, styles of parenting, and ways of dealing with problems. Many of these dimensions of culture may hold some significance for the problem of stuttering. If we look at stuttering as though we have a sub-culture of individuals who have some things in common that focuses on the word "STUTTERING", and in turn on the problem of stuttering, we can see that the diverse segments of the culture have had a powerful and enduring impact on its members. Sometimes these impacts have been beneficial and integrative, and sometimes they have been punitive, misrepresentative, and divisive. Each of the sub-populations has contributed to and reacted to one another, sometimes simultaneously. This culture of stuttering, and its individual segments still exists, is active and is still evolving. In many ways it is similar to the cultures that have developed involving the deaf, the blind, the mentally challenged, and the Little People.

As we look at the current state of affairs regarding the problem of stuttering, we certainly become aware of its multidimensionality, and its diversity of thought and activity. There are many sources of contributors to the issues that have gained our attention. It is as though a multicultural entity has evolved, from different segments and populations within our society. Each segment has had a significant impact. These would include the stutterers and their families, the theorists and researchers of this problem, the speech pathologists who clinically work with stutterers, the writers and academicians who educate students and the public about stuttering, and our larger, general society of non-stutterers, who may interact with some or all of the other segments who are more actively engaged in the culture of stuttering. It is interesting to note that some of us are members of more than one segment, and as a result may have a more powerful impact on the culture as a whole.

It appears to be timely, and might even be helpful if we addressed some of these issues as we think about the present and future status of dealing with this particular communication problem. Let us start with the early theorists and researchers, who also functioned as clinicians, and applied their ideas to help people who stutter. These were the pioneers who many years ago strongly influenced the future, and whose ideas are still some of the most prevalent present modes of thought and therapy for stuttering. They are well known, highly respected, and made very significant contributions to all aspects of the problem of stuttering. They include Charles Van riper, Wendell Johnson, Joseph Sheehan, Oliver Bloodstein and Dean Williams, to name only a few of the many who early on contributed so significantly. It resulted in Johnson's Semantic Theory, Sheehan's Approach-Avoidance Conflict Theory, Van Riper's Deliberate Stuttering Modification and Cancellation Tactics, Bloodstein's Anticipatory Theory, and Williams' Point of View that relates the stutterer's thoughts and beliefs about his stuttering to his behavior. Williams' publication opened the door to the idea that stutter-free speech could be a possibility for those who stuttered.

It is interesting to note, that many of these pioneers for dealing professionally with stuttering, were themselves stutterers. Their personal experiences as a stutterer gave a voice of validity as well as empathy and understanding to their diverse work and achievements. As a result, a number of their clients elected to follow in the footsteps of their theorist-clinicians, and in turn became clinicians and academicians who focused on the problem of stuttering, in the same way as their teachers, mentors and clinicians.

It was a new era of hope, because at the time that these pioneers were creatively applying their new ideas, they were also confronting a number of questionable therapeutic techniques, some of which were pure quackery, or distraction devices that were designed to temporarily make stuttering temporarily disappear. To their credit, throughout this era, in spite of their commitment to their own ideas, these pioneers kept an open mind to explore new ideas and approaches that differed from theirs, but which showed some promise of being truly helpful. For example, both Van Riper and Johnson tried for many months to change their handedness. Also, both of these men took on a major responsibility, and committed much of their own time and student and staff time at the University of Iowa and at Western Michigan University to collect data for my Master's Degree thesis at the University of Pittsburgh. I know about these "reaching out" characteristics of these men from my personal experiences of working and writing and presenting talks with them. I was warmly welcomed into their company as a young, non-stuttering newcomer, with many ideas that differed from theirs.

But the integration and evolution of sub-groups of a culture can become very complicated. In spite of the open-mindedness of the original theorists and clinicians, who welcomed and encouraged oppositional thinking and debate, this also became an era when having the problem of stuttering created a type of privileged, all knowing "insiders" group, for theorists, researchers, and especially clinicians who themselves stuttered. Being a stutterer became a badge of expertise, and an "unwritten law" emerged that questioned the thinking of non-stuttering professionals, and became a serious obstacle for their entering this non-existent club.

It should be noted that the motivations and activities of this "insider club" did not originate, did not include, and was not promoted by the early pioneers, but rather came from those stutterers who went through therapy with them, who studied with them, and eventually became clinicians, researchers, and academicians in their own right.

Fortunately, this concept of "privileged insider membership" that required one to have the problem of stuttering in order to be listened to, is now in the very small minority in the culture of stuttering, and non-stuttering clinicians, academicians, and researchers have become respectable and respected members and contributors to the culture of stuttering.

But for historical purposes we should recognize that the dominant approach to therapy that came out of this era was learning to deliberately stutter, in an easier way. It also focused on the elimination of avoidance behavior i.e. the avoidance of words, situations, people, and sounds, and learning to sustain and live more comfortably with their self identity as a person who stutters and will always stutter. Back then, speech that might eventually become free of stuttering was not a clinical goal, and in fact was thought to be a concept that undermined the goals of "Modification of Stuttering" as it is now termed.

Also, those clinicians who embraced the idea of enhancing fluency, and developing speech that is free of stuttering were looked down upon as clinicians who lead their clients down a primrose path of failure, disappointment and unhappiness. Although softened somewhat, this negative attitude about seeking speech that is free of stuttering still is very strong, especially among many of those who are committed to the tactics of Modifying Stuttering. They not only claim that it is not possible to achieve speech that is free of stuttering, but that such a therapeutic goal rejects the stutterer's self concept of himself as being a worthwhile person if he chooses to live comfortably with his stuttering style of communicating.

Although this rift still exists for many of the professionals, the behavior modification, conditioning and reinforcement theory and tactics segment of the culture, which in itself contains many diverse ideas about how to deal with the problem of stuttering, has developed a significant role and has made significant contributions to the theory, dynamics, research, and therapy for stuttering. Names like Israel Goldiamond, Bruce Flanagan, Bill Perkins, Richard Curlee, Bruce Ryan, Roger and Janice Ingham, Ed Leach, Richard Martin, Gerald Siegel, Cheri Florance, Carl Sherrick, Don Egolf, Stan Goldberg, Richard Culatta and George Shames, are just a few of the many that we do not have room to list here, who have contributed to the possibilities of helping people who stutter to eventually change their speech in the direction of speaking stutter-free and also changing what they believe and feel about themselves, about their self-identity, and changing their styles of social interaction. They have done this by applying the basic theories and tactics of conditioning and reinforcement, and anxiety reduction, both in the laboratory and in actual clinical encounters, supported by quantitative and qualitative research data, including short term and long term follow-up studies.

The impact of these experiences and developments has stirred members of both of these two differing segments of the culture of stuttering to reach out to one another, and to explore a number of possibilities for integrating these two differing theoretical, research, and therapeutic philosophies (Stuttering Modification versus Operant Conditioning and Behavior Modification ). On several occasions such early pioneers as Joe Sheehan, Lee Travis, Dean Williams, Charles Van Riper, Oliver Bloodstein, and George Wischner, took time out of their busy schedules to encourage or to congratulate me for a talk I had given, or a paper or a book that I had written, that did not reflect their point of view, but may have suggested an integration of our differing ideas and tactics as a way of thinking about what we were doing regarding stuttering.

I don't think I will ever forget an incident at a meeting of the Stuttering Foundation of America, in Jamaica, There were 9 of us in attendance, including the sponsor, Malcolm Fraser. Seven of us had a stuttering problem. Only Stan Ainsworth and myself were not labeled as people who stuttered. During an intermission, Joe Sheehan jokingly suggested that I had not been very talkative during the discussion, and that I should sharpen up my stuttering skills if I wanted to make any comments when we reconvened. It was a warm, respecting learning experience that was productive for all of us there.

Let us now look at yet another segment of this sub-culture, our non-stuttering society, and their impact on the people who stutter. These are the listeners who are faced with interacting with the person who stutters. The circumstances and history for this group is like the history for the other segments of the sub-culture For the most part, listeners in normal conversation are not used to hearing or seeing or being in the company of someone who stutters, Initially, they may be at a loss for what to do or say. Do they ignore the occurrences of stuttering, and thereby deny its existence? Do they try to help the stutterer by talking for him? There is a social awkwardness for both the speaker and the listener, and often a conspiracy of silence and denial.

Sometimes, especially with children, there may be teasing and taunting, and general ignoring of the stutterer. It can become very punitive and rejecting for the stutterer. His anxieties, his anticipations, his embarrassments, his muscular tension, his feelings of isolation and helplessness can overwhelm a person who stutters to the point of avoiding talking altogether, and crawling into a private shell and isolating himself from all social encounters. Eventually the behavior of society can result in the stutterer making benchmark decisions about his life, about his value as a person, his education, and occupation, about the nature and quality of his social interactions, about his entire style of living.

In some instances, our society takes on the role of an enabler in trying to be helpful rather than being rejecting and punitive. The stutterer may find a loving person who thinks he or she is being helpful by doing things that reduces the stutterer's need to talk, such as ordering in a restaurant, making telephone calls, purchasing things at stores, or answering questions for him or her at social gatherings. In the close company of such a caring and loving person, the stutterer greatly reduces his opportunities to get control of his disabling style of communication, and his chances for taking over responsibility for his style of life.

It is difficult to summarize this discussion of stuttering through the eyes of it being a sub-culture. Generally, we can see both positive and negative inputs into its composition and nature. In many instances, the stutterer is targeted, isolated and separated from the idea of being a normal human being, by society in general, by himself, by his family, and by some of the theories and therapies that are still with us, and that he or she has lived with.

But there have been some positive evolutions as well. There has been a bonding among stutterers as a group that has emerged from the self-advocacy groups that have developed nationally and internationally, that has addressed the problem of isolation, and feeling alone. The stutterers have benefited from hearing the voices of others who share their problems, and from being able to express themselves in a group, and being able to vent their feelings without being judged by their peers for what they feel.

Certain therapies have addressed the many different types of issues, feelings and behaviors that are a part of the problem, like avoidance behaviors, negative self-valuing, and self identity, frustration and helplessness, as well as the actual style of communicating. In therapy, stutterers have been given the chance to adjust to change. Even positive change can be stressful, because of its pervasive impact on one's style of living.

There have been positive developments for all of the segments of the sub-culture of stuttering. But there is one significant recommendation to enhance its durability. Every segment has to stay in contact with the other segments, whether it involves differences , disagreements, or integrations; even to the point of cooperative research projects, and co-authoring publications. Communication and learning from one another is the long-term solution for coming up with the best answers for this very complicated, multidimensional communication problem. Observing each other's differences, and similarities, respecting and understanding each other's ideas, examining how the tactics that differ from your own may have application to your own work and possibly improve it. This would include an examination and discussion of the logic, the validity, and the reality of each phase of the scenario of the therapies being considered. This would include evaluations of the tactics, goals, case studies, and long term follow-up assessments, not merely of a quantitative nature, but also of a qualitative, humanistic nature concerning the impact that the therapy has had on the stuttering person's life, and on the lives of his family and friends.

A functional culture is one that can bring differing ideas together and have as its goal a process of identifying and integrating the best of the individual inputs from each part of the whole. It is my hope that this discussion stimulates your thoughts, your discussions, your open-mindedness, and your joint risk taking, as you think about the many dimensions and possibilities of your having an influence on this thing that I've suggested can be viewed as the Culture of Stuttering.

You can post Questions/comments about the above paper to the author before October 22, 2006.

March 13, 2006
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