reprinted from Journal of AMA, May 8, 1909, p. 1480-1481
History -- Mr. A., aged 38, had written shorthand exclusively from 14 to 18 years of age, and then shorthand and typewriting with very little longhand until 22. After three years illness he took up shorthand again for one year. He then
The patient was sent to me by Dr. W. S. Thomas of New York City with the suggestion that it might be a case of stuttering in penmanship and that the methods
The therapy was based on the theory of stuttering that had substantiated itself for speech. The stutterer
Applying this principle to the penmanship stutterer, I sought a method of imparting thought by written characters that would involve graceful and easy move-ments of the right arm and hand. This method had to be entirely different from penmanship and yet capable of gradual change to it. Chinese writing brushes were bought. These made it possible to use free and grace-ful movements of the arm. A new alphabet had to be devised in order to have no connection with the pen alphabet.
For the letter A it was explained that the Egyptians had used an inverted bullock's head; for B they had used an outline of a two-story house; C was the symbol of the crescent moon, and so on (Fig. 3). All the letters were thus regarded as hieroglyphs and felt to be new things. In this way a new means of com-municating thought was built up which was quite dis-connected from the compulsive fear. The patient was trained to write the letters with the brush until he could make them gracefully and quickly. Then he passed to words, using specially the names that he had to write in his business.
When he could write gracefully with the brush he passed to a pen and drew the letters in a similar fashion. Gradually the speed was increased and greater fluency obtained.
It was constantly impressed on the patient that he was writing in an entirely new way. He learned to know that he could write perfectly and fluently in this way. Any new form of writing might have been used, but this particular form was chosen so that the final result would not differ from the usual style of penmanship.
It is essential that the stuttering patient shall always feel that he is writing or speaking in a new way: so long as he has this feeling he will be free from the compulsive idea. The mere supposition that he is speaking in a new way is often sufficient to instantly stop stuttering in speech. One patient could not dic-tate to his secretary. To avoid discovery by his superiors he would write his letters in long hand and pass them to be typewritten. I told him to sing various letters to me. He could do so per-fectly without hesitation. But he was unable to dis-tinguish one note from another, and instead of singing--as he supposed--he really only spoke the words in a kind of monotone. I sent him hack to his secretary with the instruction to always sing his correspondence, knowing that he really would not sing them but that so long as he believed himself to be doing so he would have no trouble.
This principle of training a patient to use an entirely new set of thoughts and movements in accomplishing an act that has become disturbed through nervous troubles may be applicable in still other diseases pos-sibly in the various phobias. It is certainly closely related to the Fraenkel treatment for locomotoataxia.