What I call the Primary Paradox, more than any other aspect of stuttering, accounts for the tremendous confusion that has always surrounded this perplexing disorder. It's easy to fall into this pothole. The paradox is this: If PWS can be fluent in some situations, why can't they be fluent in all situations? Why is fluency so variable? That is, why can most PWS speak fluently when speaking alone or to a pet -- but stutter when aware of a human listener? And why can most PWS speak fluently when chorus reading (reading aloud in unison with someone else)? This may seem to suggest an emotional or psychologic cause, and that's where we let ourselves be tricked. But this apparent paradox can be explained neurologically -- by the excitation feedback component of stuttering.

This paradox has tricked persons who stutter (PWS) and speech-language pathologists (many of whom are PWS themselves) down through the ages to the present day. The stuttering literature is jammed packed with inaccurate theories and ideas due to misunderstandings based on this key element of stuttering. People tend to leapfrog their reasoning ability when confronted with this apparent paradox.

When I first began chatting with other PWS at NSP conventions, I was struck by the reluctance of so many of them to recognize or acknowledge the biologic/neurologic basis of stuttering. Most PWS seemed to be stuck on the idea that stuttering is an environmentally acquired emotional or psychologic disorder. They appeared to believe that, since they could be fluent some of the time (the Primary Paradox), this proved the cause is emotional. And most of the information they had been exposed to said so, too. And many seemed to think that if it's emotional, the solution lay hidden but close at hand, and all they needed to do was find the proper key to peel back the layers of their psyches and the answer would pop out for them to grasp. I felt bad for them, because they were chasing a ghost. They were chasing with faithful certainty something that didn't exist.

This attitude by PWS made me take a step back and ask why? Something that seemed so obvious to me -- the neurologic basis of stuttering -- was not at all obvious to so many others. Then I realized that in my younger days, I had fallen for the myths of stuttering as an emotional disorder, too -- the idea that it resulted from some murky unresolved emotional problem or issue. One book I read even convinced me to blame my mother. But then I began to learn about the brain. I learned that other disorders that were once thought "emotional" or "psychologic" in origin were being unmasked for what they truly are: biologic disorders based on a physical flaw in the brain. Such disorders include epilepsy, Tourette's disorder, dyslexia, clinical depression, panic disorder, attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), and the like. Why is stuttering the last bastion to fall?

Don't get the wrong impression -- there are many PWS, SLPs, and researchers who do recognize the neurologic/biologic basis of stuttering.

There were two basic reasons that I was fooled. They may be the same reasons so many other PWS are fooled, too. One of those reasons is that almost everything I read said that stuttering was an emotional disorder. That was all I was exposed to. Who was I to question the "experts?" Back then there were no brain imaging studies and few controlled studies on the physical basis of stuttering. The other reason is the damned perplexing nature of stuttering, especially the Primary Paradox.

Predictably, many psychologists and other "experts" made simplistic associations based on shaky premises and lack of accurate information. They came up with impossibly complex, convoluted psychologic theories or paradigms to explain stuttering. Another myth was launched: stuttering was an emotional or psychologic disorder. It found its way into textbooks and popular magazines and took on a life of its own. It seemed to make sense in a vague way, and there was no other explanation to fill the void. So the myth became firmly planted in a lot of minds. And it's hard to pull away from cherished beliefs -- especially for experts, who may have devoted a career (funding, publication in professional journals, etc.) to a certain belief system. (The "expert syndrome" can happen in any field, by the way.)

For more information on the brain basis of stuttering and the "excitation feedback" idea, click on neuropatterning for stutterers.