The following article was first published in WMU Journal of Speech Therapy, Volume 11, number 2, p. 1-3, May, 1974. It is reprinted below with the permission of CVR's son, John Van Riper. The article is referred to in Manning's, (1996) Clinical Decision Making in the Diagnosis and Treatment of Fluency Disorders, p. 38-39, where he states, ". . . Van Riper found only a very few who had severe emotional problems. These people, while they most certainly stuttered, also had emotional problems that were considerably more handicapping. His description of these clients makes for some exciting reading. . . . however, there are relatively few people who have such deep-seated emotional problems that are directly related to their stuttering."

A Handful of Nuts

by C. Van Riper

Several authors, Barbara and Pitrelli among them, have claimed that very, very few stutterers are psychotic and those who become psychotic lose their stuttering immediately. I have never counted the stutterers with whom I've worked intensively but there have been a large number, perhaps about a thousand, yet in all that host I can recall only four who could be called psychotic. Since all of them are now institutionalized, deteriorated or dead, I offer their clinical pictures.

The first one was Boris, a tiny gnome of a tailor, about forty years old. He had come to this country from Bulgaria in his youth and he specialized in tailoring furs as we discovered when the nurses in our health service complained that Boris would follow them around the corridors ogling them lasciviously. No, said Boris, he hated women; he was just mentally measuring them for the fur coat he might design for them. During out group meeting, Boris was far away from any human contact. He said nothing, just looked into space blankly. My individual sessions with him, however, were very lively. He told me how I should cure him, that I must divulge to him the magic word that would free his tongue. Some soothsayer in Bulgaria had once informed him that this would happen in a far away country. I told him I didn't know the word but I would help him find it if he would do some other things first, the activities of our regular therapy. He agreed and did whatever I asked so long as each session would conclude with some search for the word. It had three syllables, Boris said, and began with the letter D. I entered into his delusions as best I could and under the guidance of a psychiatrist friend who said he was interested but not enough to take Boris on as a patient.

After the little tailor had come to trust me he told me that he was not one person but two and the other one, the invisible one, was bad but didn't stutter because he knew the word but wouldn't tell Boris. He was right there, Boris said, pointing over his left shoulder. I even got so I could talk to his alter ego at times and when Boris responded in that role he was indeed completely fluent. His deep bass voice then was quite unlike his habitual one, so I could generally know in out three way conversation who was speaking to whom, thought there were a few times when I got confused. One of them made Boris' other self furious and he and Boris had quite a discussion over whether I should be killed or not for my stupidity, but Boris won the argument. "No," he said, "the little Doc is a nice man. Yah, he's not too bright but he's trying to help me find my word. No, I'm not going to kill him. No!" I wondered how the little tailor (I was a foot taller than he was) would commit the mayhem -- with a needle or the scissors? I had worked with him and his friend for three months when suddenly Boris disappeared and I have not seen nor heard from him since. All I have is a yellowed scrap of paper saying, "Thanks. I've found it." A shame Boris didn't share it with me. I could then go back to my birch tree and say I'd fulfilled the oath of my youth that someday I'd find the cure for stuttering. Let's see. . . "Daskalov, no, Dobrovitch. . . no. . . ."

Another stutterer with hallucinations has plagued me and several other so-called authorities in the field of stuttering for many years. Let us call him Harry. Harry writes letters to us often for he is convinced that he has found the cure for stuttering and he cannot understand why we fail to welcome it with open arms. My file of his letters is two inches thick but his theme is usually the same. It is this: whenever a stutterer stutters, the whole world must rise up and stutter back at him. Harry believes in aversive stimulation and contingencies. I provide a typical sample of our one-sided correspondence:

"I am but a live human body, and I need not report thfe the experience here, but, I am also a scientisft, therefore, I muts report my experience tom you and some of the other researchists on stuttering. In 1954, I was reading Gasner's arficle discribing how they attemped to set up a system in Baltimorfe to cure all of that city's stutterers. At that time, I experience a nerve excitafion in my brain. that is, it was a physical occurrence. the nerves of my brain activafed. This had never occurred before this date. Since that time until the present, only when I think of the relafionships of curing stutters, does, this excitation of the Brain nerves occurr. I have a monomania on thfe problem of stuttering somewhat like Wendell Johnson had. although I will be doing something elas I unconcousiouly be thinking about the problem of stuttering. This is a physical thing since thfe brain nerves excite on thought of stuttering cure for 15 million stutters, how tb do it, proof of mthod etc."

"In, 1959, I began to derive meaning from thunder sound. Some people believe thunder sound to man meaning is communication with God or dead souls. Since 1959, I have only been hit with about 10 meaning. Examples of this meaning are 'Come', 'Jesus Christ is Here' 'Get marryd', 'Stutter at Stutterer' I believe this to be a physical thing. The crach or sound of thunder will not sound of my own mind. On a couple of occations, I had to be thinking about a train of thought related to what the thunder sound expressed, but the sound meaning may come out of nothing that I was thinking about. On one occation I remember, that I was researching in library a subject and a direction meaning came to me from thunder sound because I was researching that matter. I believe this thunder sound to me communication is relavant to the problem of stuttering, because I am a stutter only because the whole world will not stutter back at me with a thunder."

Harry attended out clinic for two weeks one spring during which time I tried my utmost to get him psychiatric help -- even unto offering to pay for it myself. Harry refused. He wasn't crazy, I was -- and all the other speech pathologists in the world were too. The solution to the problem of stuttering was so obvious. Why couldn't I see its logic? He didn't want any speech therapy either; he just wanted to persuade me. After he left he wrote that he was very disappointed in my but would now contact Joseph Sheehan, Wendell Johnson and others who would have more sense.

I only saw Harry once thereafter. It was late evening one fall day when a masked man tapped on the window of our old farm house and shouted that I should open the door. With my shotgun in hand I did so and there was Harry. "I have The Answer," in intoned, "for I am a P-p-p-p-prophet!" "So you are," I said, "I'll see you tomorrow at the office and you can tell me all about it." Harry refused. "My vision is on me now," he insisted, "and I must tell you now." He tried to force his way into the house but I pushed him out and locked the door, saying again that I'd see him in the morning. I watched him walk down the lane in the bitter cold and felt badly enough after a few minutes to get into my care to give him a ride back to town. But he refused, cursing me when I stopped him. "Fifteen million stutterers and you turn me away. May they haunt you, old fool!" were his final words. From a colleague I learn that Harry is now in prison -- "Just for causing a small one inch scar' but he still seeks to persuade someone to help him solve the problem of stuttering. Just like me!

These first two clients I considered relatively harmless; the third, Carl, was not. My first encounter with him took place on the stairs to my office where I was hurrying to keep an appointment with some stutterer who had written me from an army camp in Texas. At the top of the stairs a man accosted me furiously and demanded to know why I was following him. Since he was in uniform, I introduced myself, explained that I was late and sorry and that I was glad to have arrived at the same time he did. He asked me several times if I were indeed Dr. Van Riper but only after my secretary greeted me by name did he seem to calm down.

Our interview soon revealed Carl's paranoia. Other people made him stutter; they had it in for him. They had put him in the army and he wanted out. Carl asked if his commanding officer had written me and he pawed through my mail on the desk even after my secretary had responded to my query negatively. Yes, he wanted to get rid of his stuttering but the only way that could be done was by "taking care" of the enemies "who had put it on" him in the first place. One of them was a Baptist preacher. Did I know him? Had he ever written me?

Carl's stuttering, like all of the other of these odd ones, was mild -- primarily consisting of many syllabic repetitions, never any complete blocking nor any sings of avoidance nor postponement nor struggle. His eye contact was excellent -- almost hypnotic. Every so often Carl would suddenly become very angry with me about something I had asked. For example he glared at me murderously when I began to delve into his family history. All in all, a most unsatisfactory examination session that ended only when he gave me the name of his commanding officer and ordered me to write him requesting his immediate discharge.

After some soul searching I decided not to honor his demand and forget all about him until about a year later when I received a phone call from Atlanta. It was Carl. He was out of the army at last, he said. No thanks to me. He knew I'd written his officer to put him in the hospital under guard and to give him shock treatment. "Well," he said, "You'll never do it to another stutterer." Carl said he was going to kill me. "I'll be seeing you, Doc," he said. "Take care!"

That next week provided a series of phone calls from Carl, each with the same threat, and each from a city a bit closer to Kalamazoo. Then I had a phone call from a woman who said she ran a rooming house for transients and that a man who talked crazy-like told her he was going up to the college to shoot him a Professor Van Riper. She said he had something in his pocket that bulged like a pistol. So I called the Chief of Police who pooh-poohed the whole thing. "Hell, he hasn't done anything yet, has he? If we arrested every bird who made threats we'd have to use the schoolhouses for jails. If you find he has a gun on him, we'll send a man up. Just call us."

So I went to the lab, got a small crowbar we'd used to open boxes, and had a student, now head of a Department of Communication Disorders in the mountain states, rehears the act of hitting an imaginary man over the head when I gave a signal. I hoped that our hurried rehearsal had been sufficient when my secretary called to say there was a man to see me. As she ushered Carl in I couldn't help but look and yes, there was indeed a bulge in his side pocket. Surprisingly, he seemed to be in an excellent mood and wanted to talk. Perhaps the cat playing with the mouse, I thought, but I went along with the conversation. Then I had an inspiration. I told Carl that I had described his problem to a doctor friend of mine who had expressed a real desire to see him and that I'd sure like to have a report of his findings before beginning the stuttering therapy. Carl seemed pleased and interested so I called a psychiatrist and made an appointment for that afternoon. Late in the evening the psychiatrist called me at home to say that he had examined my patient, that Carl was a bit schizoid but harmless, and that he would see him a few more times before sending him on his way. He asked me if I'd pay the bill and I agreed. I tried to tell him about the threats I'd received and the evidences of paranoia I'd discovered but he just laughed. "He's harmless. Quite worrying. He's not the kind to do anything."

The next morning when Carl arrived, my student was in the office adjacent to mine, the door was open, and we had rehearsed a bit more. Fortunately, for Carl was very surly that morning. Yes, he'd seen the doctor and he didn't think much of him though he'd go back that afternoon for one more examination. The conversation was very strained and unproductive and his hand kept straying toward his side pocket. Finally, as he got up to leave, he patted that pocket and said, "I give you one more day to live, Doc. I know your game."

So I called up the psychiatrist and lied. "Carl has just been here and I thought I ought to warn you. I think he has a gun in his pocket and he told me that he's going to kill me tomorrow but that first he'll kill you this afternoon." I never saw Carl again. The psychiatrist had him in the back ward of our state hospital for the insane before nightfall. My former student should know that I still have that crowbar in my office.

The last of my handful I shall call Josie. She was a tall, angular female of uncertain age who had been referred to us by a midwestern university clinic. I always resented it a bit that they failed to inform me that Josie had previously been a patient in a mental hospital there for two years. For most of the year Josie was fairly sane, if a little bizarre, and it was fortunate that I began my therapy with her in the fall for every spring she went off the deep end into a real psychotic episode. Our therapy was very easy and very successful. By Christmas Josie was entirely fluent in all situations and under all conditions. She stayed that way until the first blossoms of May when she relapsed badly -- a pattern that repeated itself for the six years that I followed her case and until she moved out of our vicinity. Each time she relapsed Josie had a new hang-up to accompany her renewed stuttering. I shall tell you only about the two final ones.

Josie appeared again at the clinic on the second of May that year after scaring my wife with a visit to my home while I was on a trip. "You are a fortunate woman, Mrs. Van Riper," she said in the hollow lugubrious monotone she often used when her stuttering was bad. "You have a lovely young daughter and I have none. You have a brilliant husband and I have none. Do you think that is fair?" Her long silences and piercing gaze were hard to bear. Anyway, that year Josie asked me for five hundred dollars. "You see, Dr. Van Riper, it cost me that much to go to the other University. Now that you've c-c-cured me, "I'd like to have the money back, please." Every session we had with Josie ended with the same request and there were times when I contemplated paying the ransom if she would only let me alone. But June came at last and Josie was fluent enough again to go her way.

I could tell many talks about Josie but will content myself with the one about her final appearance the following Maytime. In she walked, as gaunt and awkward as ever, sat herself down not across the desk but to one side and fixed her piercing gaze on what I thought was my belt buckle. She never looked directly at my face in all of our interview as I made arrangements for another booster session to tide her over the pangs of springtime. Finally I asked her why she didn't look at me and she replied, "Dr. Van Riper, as you well know you have given me a compulsion and a complex in exchange for my stuttering. I now cannot take my eyes off the fly of a male's pair of pants. My eyes are glued to his crotch, sir, and I cannot remove them. I would appreciate it, sir, if you would take away this curse."

So I did. I told her that the only way to get rid of it was to fake some highly voluntary stuttering and that every time she found herself fixating with her eyes or having some involuntary stuttering she should do that pseudostuttering very deliberately. Lo and behold, the formula worked! Within a week she no longer had to look at male bifurcations nor to stutter. She was very fluent and free as she came gratefully to tell me that she had a new job in the hospital as a lab technician and no longer needed my services. "Also," she said, "I have a new hobby. I've taken up fencing."

Hurriedly I crossed my legs.

added with permission of John Van Riper
August 26, 2000