Peter R. Ramig, Ph.D., Professor
Department of Speech, Language and Hearing Sciences
University of Colorado
Boulder, Colorado 80309
One of Several Contributions to
Various Paths to Long-Term Recovery From Stuttering
Seminar Presented at the 2nd World Congress on Fluency Disorders
San Francisco, California
I was successful in making a significant change in my stuttering in my mid-twenties. Prior to that time period, I had received treatment for many years in the public schools where I received the support from my clinicians that eventually became the foundation for my later change. Those ingredients which built that foundation were 1) caring, b) understanding, and c) encouragement.
MY IMPRESSIONS OF THE FACTORS MOST RESPONSIBLE FOR MY CHANGE
Factor 1: Desperation/Motivation
I believe the desperation I felt became a motivating force behind my eventual change. I believe my stuttering had worsened over the years because I tried desperately to avoid and conceal it as much as possible. My frustration and shame increased as did my tension and struggle during speaking. I believe I finally had the maturity to understand and accept that my stuttering was not going to magically disappear; instead, I realized I needed to become proactive and responsible in order to change.
Factor 2: Caring, Supportive, Knowledgeable Speech Clinicians
The two clinicians who helped me change in my twenties were both caring, supportive, and knowledgeable. Stuttering therapy can be difficult at times, thus, knowing I had clinicians who supported and cared about me was a crucial factor. Also, the respect and confidence I felt for my clinicians kept my motivation level high and enabled me to push myself when faced with challenging therapy tasks.
Factor 3: Confrontation and Modification of Stuttering
This was probably the most important and necessary aspect of my treatment that enabled me to make a permanent change in my stuttering. Once I began to confront stuttering, my fear and apprehension lessened, allowing me to focus on the learning of techniques to help me stutter more easily. In short, I became more fluent by allowing my stuttering to occur, as opposed to adopting techniques focused on avoidance and concealment of stuttering. Once I became more desensitized to the fear of stuttering, I was able to voluntarily change how I manifested my stuttering. Through confronting and controlling my stuttering, I became much more fluent.
Factor 4: Learning That Much Of My Hard Stuttering Resulted From My Attempts Not To Stutter
It was important for me to understand how normal speech was produced, and how my attempts to conceal, hold back, or force actually contributed to and fueled my stuttering by tensing and interfering with the on-going operation of the system. Once I realized and understood that my attempts to avoid the moment of stuttering caused me to tense, thus interrupting my airflow and voicing. I was better able to consciously practice moving forward in speech while maintaining these two most crucial elements necessary for the production of speech. Indeed, as the late and great Dr. Dean Williams used to say, "people who stutter typically interfere with normal speech production in their attempts not to stutter."
Factor 5: Learning To Monitor My Speech Via Proprioception
In addition to the confrontation and modification of stuttering, I also worked on the establishment of fluency. Through the use of delayed auditory feedback, I learned to cue into continuous voicing and placement of articulators during slow speech drills. By learning to consciously cue into the kinesthetic (awareness of the movement and position of the tongue, lips, etc.) and tactile cues (sense of touch and contact) of speech production. I was better able to implement pre-block and post-block modification corrections. This monitoring gave me the skills to cue into specific stuttering loci and facilitated my ability to more easily modify stuttering moments.
Factor 6: Disclosing The Fact That I Am A Person Who Stutters
As I stated above, trying not to stutter tends to create or exacerbate existing stuttering. By casually and nonchalantly mentioning that I stutter when I find myself dysfluent or anticipating stuttering, my self-consciousness is reduced, and I give myself "permission" to confront and modify stuttering moments. In mentioning that I stutter, I may follow-up the statement with something like, "I think I need to work on my stuttering for awhile to help me get back on track." By bringing into the open a problem that may otherwise embarrass both the listener and me, I am able to constructively work at modifying my speech in a way that allows both of us a greater level of comfort.
Factor 7: Experiencing More Fluency And Controlled Stuttering In Situations I Once Feared
This successful transfer of my new skills to situations where I previously experienced difficulty was imperative. Once I began to experience success in a situation, I began to anticipate that same situation next time with less apprehension and fear. As a result, I eventually entered into new situations knowing that "I could do it." Feeling confident is a positive state of mind. As a result of not feeling dread as I had prior to treatment, my tension level was greatly reduced, enabling me to produce more fluency and smoother, shorter episodes of stuttering. Over the years I experienced more and more speaking situations where I was able to experience success, eventually generalizing my feeling of "I can do it" to most life situations.
Factor 8: Don't Ever Give Up
For the older teen and adult who stutters, changing and controlling stuttering means perseverance and determination. However, constructively working at changing dysfluency is less effort and frustrating than continuing to fear stuttering to the degree of expending enormous energy and concentration in attempts to hide and conceal. My best advice is, "DON'T EVER GIVE UP!"
In summary, I believe all of the factors I discussed above were equally important in my recovery process. I personally needed more than fluency shaping and more than modification of stuttering. Primary to my change was learning to modify SPEECH in a variety of speaking situations, a concept Dr. Hugo Gregory so often talks about. To do so, I needed the teaching of both fluency shaping and stuttering modification.
added with permission, August 25, 1997