Case Study 2

I am an international 18 year-old student who is currently a freshman in the United States, studying Bio-Medical Engineering with hopes of one day entering Medical School. I have been stuttering all my life.

My little brother started stuttering quite acutely when he was young. By this time, having been to several speech therapists in several countries with me (I must have been around 13), my mother was almost an expert in the field of speech therapy, and took it upon herself to help my brother. She taught him all the techniques, the relaxation and breathing exercises, and they together implemented them in the very relaxed setting of home. I can remember a particular time, which may better describe this situation:

My brother and I went to the same big school, and my mother used to drop us there every morning. One day, while we were in the car, with me sitting in the front and my brother sitting in the back, with his head thrust between the two front seats jabbering away, my brother got stuck in a nasty stutter. My mother spoke very slowly and calmly, and said, "Here, like I showed you." With her hands, she made flowing gestures to suggest free-flowing air, and then repeated, slowly, with perfect use of the technique, what he wanted to say. My brother emulated and excelled. The technique always worked, and now, as a 9 year old, I would say he has completely outgrown his stutter. He is as fluent as everybody else. He still occasionally gets stuck, maybe because of the genetic predisposition to get stuck (the "dopamine" theory, or the "focus stress on vocal cords" theory), but it can hardly be called stuttering.

This came at an age before the stress, fear, and shame associated with stuttering had developed in my brother. I don't think he ever knew he stuttered. I think he just saw it as my mother teaching him how to get out of troublesome situations. And the "therapy" that my mother used was completely NO-STRESS, NO- TENSION. Many people could say that this may be more detrimental than helpful to the child, because it can make him notice and feel nervous about something he had not noticed earlier. But my mother was incredibly loving, supportive, wise, knowledgeable, relaxed and insightful. She put my brother under no pressure whatsoever. She knew that speech therapy does not necessarily produce a cure (as in my case), and she knew that almost 10 years of therapy in my case did not completely rid me of my stutter, although it helped tremendously. She was in no rush to produce results. She could have waited forever, and not introduced a single element of tension, apprehension, or "when is this gonna go away?" sentiment into her "therapy" sessions. It proved to be tremendously helpful for my brother.

I acknowledge that I am not a doctor, or a clinician, or a therapist, and neither is anybody in my family. I'm sure many of the people here would not fail to remind me of the controversial nature of this "therapy", which is why I am NOT gonna suggest that you use it. I only would advise you and your cousin to read books, use the internet, phone the organizations about stuttering or whatever, and gain as much knowledge as you can about stuttering. Don't display the embarrassment or anger that other parents might display. Replace it with knowledge and expertise. Be loving and supportive of your child, and don't let it feel for one moment that its stutter is gonna get in the way of any aspect of its life. Just remember that when other children are playing around in the playground, with absolutely no worries, your child is going to have to deal with something significant. This will teach it the value of effort, hard work, determination, willpower and patience. Your child will become one tough, little cookie!

Below I share some e-mail correspondence between my mother and me.

Dear Family,

Here I am at the university and it is 10:20 pm. My day starts at 2:00 pm tomorrow, so I just wanted to write in to you, and inform you of the battles that rage in my head, before going to my room and doing a bit of homework.

I don't know where to start, because these are all just rambling thoughts going round and round and just making several appearances disguised as other thoughts, but then revealing themselves to be just the same thoughts wearing different garments.

This summer, when I was dealing with the issue of coming to university, all I wanted to do was this: Get a driver's license, and get back to my country more fluent (much more fluent) than I left it. I did not want friends, I did not want to live, I just wanted to take advantage of my anonymity here by undergoing intensive self-speech-therapy to help me when I got back home, where I considered my real life to be.

However, I got friends, met people, and developed a life, but still my stutter occupies my thoughts significantly. This happens on these occasions: essentially, when I think of coming back home at Christmas, and re-getting into the swing of things over there, with people who have grown 1 year older, and have become more scrutinizing - and when I think of work in the future: how am I gonna handle that, what am I gonna say (we spoke about this over the phone).

Let me start by saying that I have begun doing stammering exercises in my room. I hope to do this everyday. I read aloud while recording my voice, and I devote a big chunk of the day to speaking in a pathetically slow voice. I have decided that my use of tricks has to end: For example, at the beginning of the year, I would say, "Tell me, how are you?" rather than "How are you?" because I could not say the "h" sound. I have decided that my use of tricks, although helpful and could be used all my life, essentially reinforces the notion inside me that I cannot say "h" or ask "How are you?", which may affect other parts of my speech (like saying "Hello" on the telephone).

Using this, I can achieve close to 100% fluency almost everyday, and can sometimes feel as if I am really gonna kick my stutter into oblivion (this may sound unrealistic, and I know it is, but I hope to one day do just that). The ONLY thing that matters to me at this point more than anything else is seeing that I am achieving PROGRESS in the pursuit of my goal. PROGRESS. In any other thing, progress is relatively easy to see and measure, but in stammering, it may not be so, and this in itself also occupies my thoughts frequently. For example, I do not stutter a single time when I read aloud. This is a perfect example of perfection not signifying progress. So what if I speak fluently while reading aloud? Even the most acute stutterer may do that, yet his whole life may be severely affected by his stutter. This inability to measure my progress really turns me crazy. For example, euphoria following a day of good speech may be completely thrown following a nasty stutter while meeting someone, when I become miserable. Another thing I hope to kick is that "face" I do when I wanna say something but can't. When I do that, I really get angry. Although I am virtually 100% fluent with the people I hang around with, it is difficult to see progress from that too, because I just may be substituting my fluency with Abu Dhabi friends with my fluency with Baltimore friends. I still fear the same situations, and I still may stutter, even severely, in these situations. That, as I told you before, makes me feel as if I am staying in the same place, and not moving either forward or backward.

This is where I start thinking about going home, and facing the task that I have been terrified of all my life: speaking to other people's parents. I want to talk to those bastards as fluently as possible, in the best Arabic that I can, and have them look at me in admiration, rather than subtle sympathy with the message "Poor guy! He almost could have made it!". I don't want sympathy from anybody, because it might help me now, but it will be a severe impediment in the future, when I wanna be taken seriously.

I have written for 40 minutes and am gonna go back to my room. Please respond. I will finish this later . . . . . .

Dear Family,

Here I am on a Friday night. I just thought I'd write to you to tell you what is going on in my little mission to control my stutter:

On Wednesday, Dr. S told me that stuttering is cyclical, and that bad speech is followed by good speech and vice versa. Well, I don't know what cycle times he was talking about, but over here, the cycle times I experience are a few days. It's really interesting, my days are either fluent speech or normal speech. By normal speech, I mean the speech that I have become accustomed to at home. By that, I mean, unefforted speech, in the sense that I make no effort to be fluent, and I speak at uncontrolled speeds. Fluent speech is 99+% fluency at slow speeds.

Let me tell you what happened the past week. I was making good inroads in my speech techniques, and I saw a boost in my fluency. This might have been influenced by my meeting a few girls who live in my building, one of whom has been giving me the vibes, and my perfect fluency when talking to them in normal speeds. Also, my fluency with people I know but not too well was also improving rapidly. However, a few days ago, I realized that I was speaking fluently but not putting in the effort to do so. I was talking quickly and fluently, with absolutely no stutter. My conscious realization of this actually made me slam on the brakes, thinking to myself, "Don't speak too fast! Slow down!" and this actually made me stutter because I was thinking about it. It's strange to talk about it. I am convinced that nobody can understand except for another stutterer. However, the stuttering did not bother me, because I knew I could control it.

The stuttering continued, through the support session, which I told you on the phone depressed me, and yesterday, because I met someone but spoke really quickly and "normally" (ie. like I do at home) when speaking with him. This bothered me not because I stuttered, but because I was using the habit that I was trying to kick. By habit, I am referring to the conditioned neurological response that I have adopted over time, that ignites my typical stutter.

Today, however, I have pulled out of this "bad" slump and am again speaking in slow speeds, and making an effort to be fluent. I have learnt and am trying not to think too much about it, and not to think "OK. That's it! Problem solved!" and stop using the techniques, only to drift back into dysfluency. My attitude is this: Think about it, but don't think about it! Measure your progress, but don't measure your progress! After a few incidents in the past (such the one described above) I feel I am getting closer to achieving that goal.

Another strategy I have adopted regards the cyclical theory of Dr. S. I see a good speech cycle as a wave that I try to stay on for as long as possible. Now, in the past, I have fallen off this wave, as I described above. But I feel that I stay on these waves for successively longer periods of time. I have become better at staying on these waves. Also, upon falling off these waves, I try to minimize the time I spend in bad speech by trying to get onto the next wave as soon as possible. Again, I am getting better at this. My bad speech days don't last more than a few days, although I can go around a week with good speech.

Another strategy I have adopted has to do with government economics. Steady growth, is better and far more important than, fast growth. If I shoot up, then my chances of shooting down are quite high. What I want to do is go up steadily, advancing slowly but surely, and fortifying my conquests so that I cannot lose them again. This is what Dad would call, "Building up your confidence slowly slowly!"

So after all this psycho-talk (pardon me, but I have been doing a lot of thinking about this subject), I would like to give you an evaluation of my speech at this moment.

I shall separate the people I interact with into 3 groups:

  1. Very well: my good friends on campus, my friends who I talk to on the phone, my family, my room and suite mates
  2. Somewhat well: people I have met and talk to on campus, but are not too close to
  3. Not well: strangers, and people who might intimidate me like SOME girls (or the occasional guy)
With the Very Wells, I speak fluently without any substitution techniques. The only words that give me problems are the ones that start with: str-, spr-, fr-, thr-, and scr-. These have been giving me troubles all my life, and rather than substitute them, I now try to use them more often, something I shall call artificially-induced stuttering. Notable troublesome words are: from, through, freshman, structure, scratch, friend. If it weren't for these I would be absolutely 100% fluent in the presence of these people.

With the Somewhat wells, I also speak fluently but with the occasional substitution, usually to avoid troublesome common words like from and through. I find it difficult to ask questions. My roommate wonders why, since I am putting THEM on the spot, rather than vice versa. I suppose it has something to do with the inflexible nature of asking questions, compared to the seemingly limitless ways of telling a story. For example, every question either begins with How, Who, What, Where, Why, Do, and Is. These words in this context can sometimes be incredibly difficult to utter.

With the Not wells, my fluency has been getting better, but I am still sometimes dysfluent.

In Arabic, I am fluent with the Very Wells, but I have to use techniques a lot, and I have to speak slowly. The "aa" sound bothers me, as in: Omar, Amman, Abdoun, Ajman, or as in the beginning of sentences like: Aam badrous la'l Imtihan, but I am improving quickly.

With the Somewhat Wells, I speak Arabic quite well, but have to sometimes seed it with English, rather than using my techniques.

With the Not Wells, I try not to speak Arabic.

The general trend is improving though, and I shall report again very soon.

Love, your son

What follows are messages responding to my letters above. Let me first please note that we have an Arabic saying that goes: "A Monkey in his mother's eyes is a Gazelle!" This saying really applies to these messages, so please do not take their "fluffy" content too seriously. Second, the few mentions of God in these messages make me feel that I should announce myself to be a Roman Catholic Christian.

Dear son,

I have so much to say that I don't know where to start from. So I will pour out the ideas as they come. That's what e-mails are all about!!

Beloved son, have you ever heard that worry is like a rocking chair. It moves but it takes you nowhere. I remembered it when you told me that you are putting the effort but you find out you are still in the same place. Well dear how can you progress when the vehicle you are using is the same one that is bound to keep you in the same place?

You can't gather your life past, present and future in a nutshell and worry about it. If God had meant it to be so he would have given us one day to live even a minute, but life is not meant to be gathered in the palm of a hand and judged, scrutinized and summarized with a conclusion: success or failure. Oh no my dear, not at all, the beauty of life is that it happens one day at a time, one moment at a time not in a rush and not in a continuous pattern: what is up today is down tomorrow and vice versa. So how can you see your days to come and judge them as incompetent? and who are we talking about? Son, the most handsome, the most intelligent, the most noble of all creatures on the face of this earth. He sees himself as incompetent and stuck in a rut. Oh my dear, if you could only see what we see and when I say us it is not only us your parents but everyone: parents, brothers, sisters, cousins, relatives, far and near friends, employers, colleagues, everyone. Yes my dear, you are a precious jewel that everyone admires so look at yourself from where we stand and you will love what you see. Stop putting yourself down, love yourself because you can't help but do that if you count your blessings: the ones God bestowed on you by birth and the ones you have developed with your own skills, like your character, your personality, your sensitivity, your nobleness etc., etc., etc.

You are running ahead of the events, ahead of the days, that is what worry is all about. How do I know? I do it all the time. You are tired, panting and discouraged. Stop running right now. Sit, stand, lie down and stop running otherwise you will consume your energy. You have to take every day at a time. If one day you fail another day you will succeed. A friend once told me that she couldn't drive because the sight of so many cars at a distance ahead of her scared the wits out of her. Then she realized that as she came closer to the cars they did not appear so many after all and she could place herself smoothly among them and that it was alright. "This," she told me, "I remember every time I encounter a problem." How wise and simple to follow. When you look from a distance at your future you tend to see stammering problems blocking the way and you decide not to approach at all. This is a dangerous practice don't do it. Take every day at a time and in a relaxed manner. The days will flow smoothly to form the brilliant future that is awaiting you.

How do you tackle the day I am talking about? First and foremost, you should work on your state of mind. What are you afraid of? I will categorize it into the following: Time, deadline, age, adulthood.
Impressions on people.
Ability to communicate.
Ability to live your life to the fullest.

Probably your potential and your realization of what you could do had you not had the stammering problem is an impediment in itself and activates your sadness and your frustration. But I know that you are too intelligent to let this problem rule over you. I am sure of that fact.

Well my dear it is alright to be imperfect, to have a weakness. Probably God gave it to you to put some meaning in your life, to make you more aware of the insecurities of others, to give you a challenge that you have to defeat. You have too many good things and if one thing is not perfect it is alright. My father had told me once, "your life is too smooth, having some difficulty is even good for you." I remember his words until now.

So we come to the issue of acceptance. The issue here is intricate and complex. if you insist you don't want to stammer, you will stammer and if you accept it, it will go. When I say accepting it, it is not in the sense of not wanting to change it, no, but relaxing about it. So during that day if you feel in a certain situation you are going to stammer say to yourself "What if I do, so what?" and you will relax. But if you are uptight and afraid, your very same uptightness will bring it on. Being accepted?!!!!! Well you have so much to offer that people want to be with you. They admire you and love you. Your huge number of friends is a proof of what I am saying. People don't make any deal of your stammering you are just overreacting. As for official people you are expected to deal with in the future, well my dear they will become a part of your routine and you will deal with them the way you deal with friends now. You are only harbouring bad memories from past experiences that keep threatening in moments of weaknesses, don't let them do that. Don't let those negative images spoil the success you have achieved, the perfect fluency you enjoy most of the times, and leave your doubts for when they happen don't anticipate them. Relax and ravish in your success. Dear son your tendency to exaggerate things now is due also to the fact that you feel very homesick and you are under a lot of academic pressure so don't worry it will pass and you will give the events again their normal size.

I am so glad you talk about stammering now, your feelings have been bottled up for too long. your father was delighted you were sharing your intimate thoughts with us. "It is a step in the right direction," he told me. He also thinks you are on the right track, exercising and practicing. "He has enough will power to get over this," he told me. "He has so much going for him, enough to make the person he is addressing feel inferior to him, and this will slowly build his confidence." Who is this person I am talking to? Does he know more than me? Is he more intelligent than me? Is he more important than me? Ask yourself those questions and you will soon feel your superiority. You are superior my dear. You know what you are talking about and everyone wants to hear it.

Dear son you had started on the wrong foot before starting your university life, and it is catching on you now. Start all over again, you can do it. You have to change your direction 180 degrees because your state of mind was completely wrong. I wish you told me about it when we sat together in the kitchen and talked about things but maybe you thought then that your little plan would work: your isolation, your anonymity as you call it would do the trick and we would be among the people you want to prove your fluency to when you come back home. Planning all your life around stammering is not right and is self destructive. Because when you want something so much it becomes an obsession and you don't want that. Don't stop your life for it. Take care of it but not all the time, you have to attend to other sides of your life that are many and learn to enjoy them and appreciate them. This you owe to yourself and neglecting this pleasurable side of your life is negative and self abusive and self destructive. You must be thinking since those things work you will put them at halt while you take care of your stammering then you will go back to them. This is wrong totally and deserves your UTMOST concern. You should learn how to think right before you practice the sounds that are difficult for you. Live your life in all its manifestations with stammering in it and deal with stammering as you would deal with anything else. Get counseling to help you approach stammering in a more positive attitude. Follow up with the speech therapist he might be out of town. I was told about a toll free number (1 800 992 9392) our friend had found in Men's Health magazine (the Nov issue).It is for the Stuttering Foundation of America. He had called them and they sent him a lot of material that he is sending you. They are even sending him a cassette, all in the space of two days. Please call them. Reading about stammering will help you a lot. For a matter of fact you never read about the subject before. DO IT. Communicating with people who stammer is very helpful, that is what support groups are all about. Avoiding them is another way of running away from the problem, as if you refuse to label yourself a person who stammers. Stop running look at stammering in the eye and admit to yourself that you stammer and it is not shameful nor does it arouse people's sympathy as you call it. It is because you look down at yourself and rub out all your credits that you think people do not appreciate you and pity you. Nobody pities you. You are pitying yourself and prefer to blame it on the people, it becomes easier to handle since you are no longer responsible for it. Take your life in your own hands and act. What you are going thru now is very constructive use it to the limit. Besides you are in the right country par excellence use the HUGE resources they have in this respect explore and benefit, you can't be in better hands.

People who stammer come from all walks of life. Your father did it and several others too. If all those people succeeded why shouldn't you? There is nothing to fear but fear itself so work on your fears, smile at life and it will smile back to you my love....


added with permission, February 23, 1997