Long Term Recovery From Stuttering
presented to the
2nd World Congress - International Fluency Association
August 22, 1997 - San Francisco, CA
In 1977 I attended the panel on recovered stutterers at the annual meeting of the American Speech-Language Hearing Association that Steve organized. As I sat in the back of the room and watched that panel of people who had "recovered" I could never have imagined that I would b standing here today. At that time in my life, as a result of treatment, I had gained some fluency. But, I continued to avoid words and many speaking situations. I was far from recovered and the fact that I was a person who stuttered was still a significant handicap.
The formal treatment I received in my early 20s began to turn things around. But it was only a beginning. Following my graduation from college I had the good fortune to work with Gene Cooper at Penn State University in the mid 1960s. The program was essentially a stuttering modification program with a few twists He called it Interpersonal Communications Therapy. I thought it was a good program because the clinicians had a sense of direction. It was also good because it brought together a comprehensive intervention strategy and a group of clinicians who believe in the approach.
Reflecting on that experience now after 30 years in the field, I've come to believe that it's important for clinicians to be using a treatment strategy that is congruent with their beliefs and possibly even their personality characteristics. Otherwise, it is difficult to be enthusiastic. Another important factor for me was the timing of treatment I received. I was at a time in my life where I was sick to death of stuttering. I had reached a point where changing myself and my speech was by far the most important thing. During junior and senior high school, even during college, many other things took priority. As an adolescent I had been referred by some of my classroom teachers for treatment. But other things were more important to me and I simply wasn't ready to run, what I suspected to be, a long and difficult race.
But now I had completed college. I had been rejected by the officer candidate programs of both the marines and the air force because of my stuttering. That was in 1964 and many of my friends were on their way to Viet Nam. It is true, I suppose, that sometimes the fact that you stutter can be a blessing. Fortunately, a few months later I was declared 4-F by the selective service because of a high frequency hearing loss. I was a mess.
So I found myself at one of those nodes in life when I was able to look around and seriously consider the possibility of change. I began to accept the fact that I had a problem, a big problem that was really in my way. This acceptance, I now realize, was the critical first stage of change. It was clear to me that my stuttering was the next big thing that I needed to attend to. I was ready to do whatever it took. I didn't care how long it might take or how much it would cost. I suspect that at that point I would have had a good start toward fluency in any one of several treatment programs. But I was fortunate to find a good program at a time when I was ready to change. My willingness to change came together with clinicians who had a comprehensive strategy, believed in what they were doing, and were excited about the program.
Treatment helped me to understand that I had a choice. I didn't have to be helpless in my stuttering. The clinicians helped me to map my stuttering and the problem slowly became less of a mystery. I began to see that there were some cause and effect relationships about my stuttering and my response to it. I saw that if I avoided certain words they became more powerful. And I began to realize that if I could sometimes hang in there and resist forces such as listener reactions and the time pressure to speak, I could begin to get a hand hold on moments of stuttering and have some small victories. Rather than always feeling afraid and helpless during stuttering, I began to realize that I could sometimes vary and change my speech a little. I found that I could stay with the stuttering rather than always wanting to run away. I could even play with the stuttering and have some fun with it. That is, I could change the form of my stuttering and experiment with it, get some distance from myself and my speech, even begin to see some humor in my situation. And, maybe most important, I found that I could also change some of my attitudes about my speech and myself.
As I said, treatment didn't completely fix me. The process of change continued long after formal treatment was completed. Important changes continued for another 15 to 20 years. It took that long until I felt I was no longer handicapped by my speech. It took that long before the likelihood of stuttering had little or no influence on my decisions - decisions about talking to people.
I believe that's what recovering means. There may still be some stuttering and maybe in some ways you're always going to be recovering for the rest of your life. But more importantly, after many years I no longer have to monitor my speech in most cases. I'm comfortable with my fluency and I don't make decisions based on the possibility of stuttering. I could, as strange as it sounds, even regard my stuttering as a gift. If you're a speech-language pathologist, being a person who stutters can be pretty neat. Among other things, your clients know that you've been on the trail and that you have weathered some storms and that you've managed to survive.
During my treatment, and especially following formal treatment, I believe it was very important for me to do more than change my behavior- the features of the stuttering that are on the surface. The quantity of stuttering is often an absolutely terrible measure of change and success. The quality of your speech, whether it's stuttered or not, is a much better indicator of what is going on under the surface. I also had to change the deep structure of my problem, the way I thought about myself and my speech and what I told myself about the experience of stuttering.
As you will hear many people on this panel say, decreasing the effects of stuttering involves much more than changing the disruption of speech flow or the impairment of stuttering. I think that it is critical to alter the person's ability to respond to their situation. To achieve long term success, you must also change the handicap, the way you and your listeners react to and make choices about the fact that you are a person who stutterers.
I believe that I could stutter more than I do and still be successful and happy. I know many people who do that. But the fact is I'm pretty fluent. Sometimes, however, I think about something one of my clients asked me last year. He said "What if I become fluent and then find out that I have nothing to say!" Sometimes that happens. It could even happen here this afternoon. Maybe it has already!
What I'd like to say in the few minutes I have left is how thankful I am for the good treatment and good clinicians I was able to experience. Never, when I was younger, even in my wildest dreams, did I imagine that I'd ever speak in front of a group like his - let alone enjoy it. I thought I had a much better chance of becoming an astronaut.
I want to tell you how thankful I am that I am able to speak fluently. I want to tell you that I hardly ever take my fluency for granted. For many years I had things to say and I refused to try. I refused to even consider making the choice to say them. Perhaps even more basic, I had things to say and I didn't even know it. It's like word processing on a computer screen- you don't know what you think until you type it or you say it. And then those ideas lead to new thoughts that you wouldn't have had otherwise. Because I expended so much effort running from stuttering by avoiding situations and substituting words, I frequently did not even know what I truly thought.
I am so thankful that I no longer feel handicapped. As I have said, that did not happen immediately, or for several years following formal treatment. But that's where I am now. I rarely stutter- maybe 2 or 3 times a month. When I do, I don't avoid, I' not likely to panic, and I have confidence that I can repair the fluency break. I won't say that it never happens, but it is extremely rare that I consider avoiding a speaking situation or substituting a word because of the possibility of stuttering. But the most important part is that the possibility of stuttering rarely enters into my choices my decision-making about living; about what to do or what not to do.
I am thankful that I can pick up a telephone and enjoy the experience. I can say exciting things and communicate ideas and feelings to my friends, my family, and my colleagues.
I am thankful that I can spontaneously banter back and forth with people; tell jokes pretty well, ask questions at a meeting, and be pretty effective in front of a group. I am thankful that I am able to connect with strangers- people I never would have spoken to and known before, on a plane, in a shop, or on the highway.
I am thankful that I have been able to take my thoughts and turn them into fluent words during good times and bad. I have been able to give eulogies in honor of dear friends, colleagues, and parents. I would rather not do that sort of thing but I am honored and very proud to do it well.
I am thankful that I can do what I am doing today, be an active colleague with people I admire, people with whom I share the same boat.
I'll conclude by saying that the news can be very good for adults who stutter. Clinical research indicates that this is certainly the case for children. But it's also possible for an adult who stutters severely to eventually achieve a good level of fluency. Even more important, it is possible for a person to decrease the handicap of stuttering to essentially zero. Often it also happens that the frequency of stuttering is reduced also. It's true that sometimes these good things happen without formal treatment. But I think that a good clinician who is genuine, enthusiastic, emphatic, and sometimes demanding, can make it happen sooner and much better. I believe that such a clinician, working with a person who is ready to take action, can create the wonderful stories that you are hearing today.
The University of Memphis
phone: 901 678-5828