This paper was part of a panel presentation at the 1997 American Speech-Language-Hearing Association Convention in Boston entitled "Generations of Science and Service: Tribute and Review in Stuttering." Other panelists were Jane Fraser, who spoke about her father Malcolm Fraser, founder of the Stuttering Foundation of America; Marilyn Langevin, who spoke about Einer Boberg; Pearl Gordon, who spoke about Hal Luper; and Mick Hanley, who spoke about Charles Van Riper. Summary comments were provided by Hugo Gregory. The session was organized by J. Scott Yaruss.
Introduction
Let me begin by saying what an honor it is to be allowed some time to present my perspective on Dean Williams' contributions to our profession. I was one of about 28 doctoral students who studied with Dr. Williams. Many of those others could have been chosen to talk about Dr. Williams, and so therefore I am humbled by this opportunity.
It’s difficult to summarize the career of someone like Dean Williams in a short presentation. For that reason, I will try to highlight what I consider to be his most important contributions to our understanding of stuttering and its treatment. I’m sure I will omit some information, but I will try to provide some background and some context for what Dean Williams meant to all of us. I will admit that it will be difficult to be a totally objective and dispassionate reporter of the contributions of someone who has meant so much to me personally.
Dean Williams as a person
I will start by briefly summarizing my observations of the personal side of Dean Williams before I comment on his professional contributions. My observations of Dr. Williams, primarily during 1979-1984, were of a man who got along with almost everyone and respected everyone. He held to his beliefs, and was strong in his beliefs, but was not confrontational. I never heard him speak poorly of anyone. I find that particularly interesting because I have been at meetings in the past where people have publicly made snide comments about Dr. Williams or mocked him. I can’t imagine him doing the same to others. He was slow to anger, quick to forgive. He became most angry, I think, when people failed to see things that were (to him) relatively straightforward. We spent many an hour in his office—his voice raised, me trembling—as we hashed out my thinking about my doctoral research. Those meetings, however, would always end on a positive note, with him reassuring me that I wasn’t as dumb as I felt, and me leaving with the sense that maybe some day I would figure this all out. Two things he often said during those meetings have stayed with me: (1) “Think deeply.” (2) “Goddammit, Bob, words have to mean something!” What I most appreciated about him was that he had a great sense of humor and liked to tell or hear a good joke (and maybe some not-so-good ones). Anyone who knew Dean Williams well can attest that he was a wonderful person.
Dean Williams as a scholar
The “point of view”
The best place to begin a discussion of Dean Williams' professional contributions is his 1957 article, “A point of view about ‘stuttering’.” In my opinion, Dr. Williams stayed true to the basic ideas expressed in that article throughout his life. That can be interpreted in two ways: one, Dr. Williams never had an original idea after 1957, so he kept saying the same things over and over again. Second, and probably more accurate, is that what he had to say was so important and relevant that it has withstood the test of time. Many people in the area of stuttering wear many “hats” during their careers — general semanticist, behaviorist, motor physiologist, geneticist, etc. “Whatever ev erybody else is talking about, that’s what I’m interested in!” That was not true of Dr. Williams. He modified his point of view a bit over the years, but the basis for it didn’t change much, if at all. I’d like to spend just a few minutes summarizing that point of view, and talking about some of the things about his point of view that are true today as well as some of the things that may be called into question today. On balance, I think we will see that what has remained true far outweighs that which has become dated or untrue over the years. For those of you who are familiar with the point of view article, what I will present will be a review. Many people are unfamiliar with the point of view or may have forgotten it, however.
Williams admitted that his point of view was influenced by the work of Wendell Johnson (with whom he studied). The point of view was based upon the idea that we needed to move away from animism or mind-body separation toward a more scientific, descriptive, process-like manner of talking about stuttering. In the “point of view” article, Williams said that (according to 1957 knowledge), persons who came to be classified as stutterers did not differ “neuro-physiologically” or with respect to basic personality structures from those who did not stutter. Williams said, “It is assumed, therefore, that what we call ‘stuttering’ is a way of speaking that has been learned by the speaker” (p. 390). In retrospect, given an additional 40 years of research, we can question the contention that stutterers are no different neurophysiologically. But the “learning” that Williams talked about relates to the “excess psychological baggage” that the stutterer adds on to the basic disfluency. Today, we would probably say that the basic or “core” disfluency is likely the result of some neurophysiological difference.
In 1957, Williams said that the stutterer comes to believe that stuttering is “part of him.” The stutterer may use feelings to determine when stuttering is about to happen. When these feelings arise, the stutterer does things that in fact are the stuttering behaviors. The stutterer fails to see the relationship between what he is doing and what he feels is happening to him. Based on this, much of what the stutterer does when stuttering is based upon his efforts to “not stutter.” This notion has been expressed by many, including Johnson and Van Riper.
Williams’ solution to this dilemma was to ask clients to talk about stuttering without using the words “stuttering” or “it.” This would require the client to use more descriptive language, but initially that descriptive language may be animistic in nature. For example, instead of saying “I stuttered” the client might say “my throat locked” or “my tongue got stuck.” To deal with this, Williams said that we have to emphasize the total process of speaking. Our clients have to know and describe what people do when they talk, and what our clients do when they talk. The goal of therapy, then, becomes not one of “getting rid of stuttering” or “improving stuttering” but of doing more and more of the things that nonstutterers do when they talk. Williams also pointed out the importance of having clients become better observers of “fluent” speech. Not only is fluency important, but other factors like rate, rhythm, and inflection are important as well. And all these things vary in different speakers. By having clients observe speech and speakers in this way, it was possible for the stutterer to develop a different, perhaps broader, understanding of his own speech, and to focus on the many things involved in talking, rather than just focusing on fluency or the lack thereof.
According to Williams, as a client becomes better able to describe speaking behaviors in this broader way, he or she is better able to understand that much of what he or she does is purposeful and perhaps more importantly that much of that can be changed. With this point of view, the client plays a more active role in therapy. The therapist cannot tell a client what to do to speak more fluently unless the client has first been able to describe what he or she does to interfere with talking.
In his point of view, Williams discussed the concept of “forward moving speech” which he talked about throughout his life. He said that stuttered/nonstuttered speech was a false dichotomy. The things the stutterer did while stuttering were all related, and many of those things interfered with the forward flow of speech. It is important for us, and our clients, to view stuttering in this way, and to analyze stuttering as a process.
It is also important, from Williams’ point of view, to teach our clients that feelings are not a good predictor of behavior. Our clients need to learn that they can speak in the face of heightened emotion and that frequently it is their reaction to this emotion that leads them to begin to do the things that interfere with speech. “Stuttering” is not holding the client back, he is holding himself back, according to Williams.
Williams said: “...the person [must learn] (1) that nothing will happen to him, that there is no entity inside him called ‘stuttering’ will stop his speech; and (2) that the feeling-of-stuttering is a faulty evaluation of very normal emotional reactions” (p. 397). To deal with this, it was important for the client to move forward into speech and to test reality.
Finally, Williams emphasized that each client is different. Because of this, we should deal with each client by discussing, on a descriptive level, his speech patterns as they vary from normal. This enables the client and clinician to be sure that they are talking about the same things, and the speaker can describe changes required to enable him to speak more “normally.”
Forty years later, we can examine what Williams had to say, and probably find a number of things to disagree with. Many people, for example, would reject the notion that the stutterer “does something” to make himself stutter. Most everyone would reject the idea that the stutterer is no different constitutionally from the nonstutterer. I’d like to take a few minutes to provide my interpretation of what Williams had to say in an attempt to make it relevant for 1997 and beyond. Much of what I will have to say has evolved from listening to Dean Williams teaching classes, leading practicum meetings, and from conversations I had with him.
I think today Dean Williams would reject the notion that the stutterer “does something to make himself stutter” at a basic level, but would hold to that point of view at another level. By that, I mean that he would not say that the “purposeful” behavior of stuttering is what causes the disorder (I don’t think he said that in ‘57 either), but he would hold on to the idea that much of what maintains stuttering is purposeful behavior. He tried to make the point that the stutterer is likely to be unaware of the purposeful nature of what he does when stuttering, and that is why Williams emphasized problem solving as the best way to approach therapy. He was aware of the individuality of stuttering and the differences in the way different stutterers spoke and stuttered. One of the most important ideas to come out of the point of view article was that the therapist cannot tell a client what to do to speak more fluently unless the client has first been able to describe what he does to interfere with talking. The “give and take” in therapy is important, and I believe that most SLPs today would say that we cannot tell our clients what to do to be fluent, but must work with our clients and help them to speak more fluently in the context of the way that they currently speak. I’m sure we have all worked with clients whose earlier therapy experiences were in what I would refer to as “passive” therapies. That is, they were told what to do by an SLP, such as “talk slower,” “breathe differently,” “use continuous phonation,” etc. They were never asked to tell the clinician about what they were experiencing, but instead were praised for improved fluency. Using Williams’ ideas, we can still use techniques like slow speech or continuous phonation, but the client is required to tell us what he is experiencing while using those techniques. We ask, “how is that different?” or “what are you doing differently?” That is another important aspect of the Williams point of view: we use language that talks about what the client is doing, not what is happening to him. The idea here is not that stuttering is a voluntary behavior; the idea is that if we get our clients thinking and thinking in terms of what they are doing, they will think in terms of what they can change. They are no longer “along for the ride,” but they now take a more active role in what they do as speakers. This “problem-solving” approach to therapy gives our clients knowledge about speech in general and their speech in particular and this knowledge is a powerful tool for them to have when they are dismissed from therapy.
A strong affirmation, albeit an unintentional one, of Williams’ point of view was stated in a post to the STUTT-L discussion list by Woody Starkweather on October 23 of this year. In his post, Woody was discussing some important concepts from Gestalt therapy that can be used with stutterers. Among other things, he said:
I have found a number of the Gestalt principles and ideas extremely useful in treating people who stutter. Staying in the here and now as far as speech is concerned is a great way to figure out how not to back up, struggle for fluency, procrastinate, etc. Similarly, being aware of the behaviors one performs during moments of stuttering leads to a better understanding of what a person's stuttering actually is, which doesn't hurt a bit, and awareness also helps a person become more accepting that what the person is doing at the moment is stuttering, not something else, as many PWS feel.
I doubt if Dean Williams would have called himself a Gestalt psychologist, but it’s interesting to see that the ideas he expressed forty years ago are being stated in a very similar way by one of the leading experts in stuttering in 1997.
(Note: I spoke with Woody Starkweather after this presentation, and he told me that he had been heavily influenced by the work of Dean Williams, so he was not surprised that his quote on STUTT-L sounded so much like Williams.)
Dean Williams made a number of other contributions, as well. Much of his research was devoted to a better understanding of stuttering in children. Some of his studies were extensions of Wendell Johnson’s research into adaptation and other now-classic phenomena about stuttering. Williams, with his students and colleagues, studied the locus of disfluencies, and the adaptation and consistency effects in school-age children who stuttered, how children reacted to adults’ disfluencies, and language skills of children who stuttered. He also investigated listeners’ perceptions of men and boys who stutter. Much of this, again, was motivated by his “point of view.” He was interested in learning how children came to believe that they were not good talkers, how they came to believe that stuttering was a part of them, and what led to the effort and struggle that develops as the disorder progresses.
In this short essay, I probably haven’t done justice to all that Dean Williams meant to our profession. People who are interested in learning more about Dean Williams have many possible sources to go to, but I have four favorites that I would encourage anyone to have a look at. I feel that these four sources, in addition to the “point of view” article, give a very good insight into Dean Williams:
Before I conclude, I’d like to make just a couple more comments. First, I hope that everyone here will leave with the understanding that the work of the “pioneers” in the area of stuttering, like Williams, Fraser, Boberg, Luper, and Van Riper, as well as many others, was not only important in its time, but is still important today. I think that many people hold the attitude that if something is old, it is no longer valuable, as far as our understanding of stuttering is concerned. Personally, it troubles me deeply when Wendell Johnson’s years of work are distilled down to “he blamed parents.” I worry that the contributions of the individuals who the panelists have talked about will be similarly distilled and distorted. We all have an obligation, I think, to respect the work of those who came before us, to understand that the nature of “truth” is that it constantly changes, and to understand that much of what we take for granted today might be much different had it not been for the efforts of individuals like Dean Williams. Most importantly, each of the individuals we have talked about today was a good person, a hard worker, a creative thinker, and was dedicated to making life better for people who stutter. That, alone, should merit our respect and our thanks.
References
Starkweather, C.W. <V5002E@vm.temple.edu>. “Re: Reply to Ed's Objections to REBToS as Prototype.” 23 October 1997 <stutt-l@vm.temple.edu> (23 October 1997).
Williams, D.E. (1957). A point of view about ‘stuttering.’ Journal of Speech & Hearing Disorders, 22, 3, 390-397.
Williams, D.E. (1971). Stuttering therapy for children. In: Travis, L.E. (ed.) Handbook of Speech Pathology and Audiology. New York: Appleton-Century-Crofts.
Williams, D.E. (1979). A perspective on approaches to stuttering therapy. In: Gregory, H.H. (ed.) Controversies about stuttering therapy. Baltimore: University Park Press.
Williams, D.E. (1982). Stuttering therapy: Where are we going—and why? Journal of Fluency Disorders, 7, 1(2), 159-170.
Williams, D.E. (ca. 1983). Talking with children who stutter. In: Counseling Stutterers. Memphis, TN: Speech Foundation of America (Publication No. 18).
© 1997, Robert W. Quesal, Ph.D.