The Benefits of Stuttering: Clearing Out Some Roadblocks to Recovery

Catherine S. Montgomery, MS,CCC-SLP, BRS-FD
The American Institute for Stuttering
New York

My talk with you today is a practical one. It’s about an aspect of my treatment program that I have found to be invaluable.The process I’d like to share with you today continues to impress me as being an essential element in the process of treatment and one, I believe, that is often missed or overlooked.

This has made a significant difference with my adult and adolescent clients and what they ultimately do with treatment. In fact, it has been the single most important aspect of treatment for many of my clients and has made the difference for them between the process of recovery continuing to be hopeful versus an experience of failure and hopelessness.

This exercise has also given me a great deal of information on why our clients relapse. Philosophically, I don’t view relapse as a negative. I view it as feedback; as information to be used and learned from and I have certainly learned a great deal from my clients’ experiences with relapse. What I’m talking about today are the psychological roadblocks that we, as human beings, encounter when we are in the process of making a major change in life.

These roadblocks are concerns, fears and even threats to one’s identity that are so pervasive they can interfere with us making the change we think we so desperately want. And very often these concerns and fears operate on an unconscious level until they are brought out into the open through a process such as this.

Let me give you an example and tell you about Ron. A few years ago, Ron, a 52 year old PhD engineer, came into my intensive treatment program in New York. My intensive is very whole person in nature and the process has many elements to it. The physical/fluency component is an integrated and evolved version of stuttering modification and fluency shaping. I work a great deal, as well, with clients in the development of the various attitudinal and cognitive strategies, work directly with fear and avoidance reduction and provide a significant follow up/support system.

As I worked with Ron through the process of retraining his speech muscle coordination I couldn’t understand why he seemed to be having so much difficulty learning the motor skills. He’d “get it” and then minutes later, he’d be off track. He’d easily lose his concentration and focus…more than the norm.

He hadn’t reported any particular learning disabilities and was otherwise highly intelligent and an apparently motivated individual. I wondered if perhaps he was unaware of some learning problems or perhaps he had some subtle motor coordination problems. What was going on?? I then wondered if there were other psychological dynamics operating here, similar to what I had observed in some of my other clients.

So, I sent Ron home that night to think about and answer 4 questions by listing:
1) What’s “bad” about stuttering?
2) What have been or are currently the benefits of your stuttering?
3) What might be the downside to becoming a more fluent speaker. Is there anything you’re giving up? Is there any consequence to pursuing this change in your life?
4) What are the benefits to being a more fluent speaker?

Ron came to session the next day absolutely amazed at what he had thought about and what he revealed to himself. He said he had never thought about any of these questions before and that no one had ever asked him these questions in all the years of treatment that he’d had .

In answer to the question What’s bad about stuttering he wrote: “Loss of self image and self worth, unable to verbally communicate in an extremely verbal world, tension, stress and toll on the body, strongly inhibits one’s personality, strongly distorts one’s personality, exerts excessive control over one’s life, promotes excessive fear of failure complex.”

The way that I conduct this in my program is in a group situation. Each person shares his/her first list. We don’t do much processing with this. It’s acknowledged and feelings and attitudes are validated. People agree with one another. If you wanted to, you could spend a lot of time discussing these feelings and attitudes, however I feel more immediate useful information comes from the next lists.

Next, each person shares list 2: Now, we spend much more time on this list as each person shares, each item on the list is discussed...sometimes at great length. This whole exercise typically takes from 3 to 4 hours with a group of 6 to 8. This can also serve as just the beginning of longer term exploration for some people such as Ron. So, here are Ron’s answers to question 2. Clearly, a longer list. For example, his first 2 answers generated a discussion about “comfort zones” and moving out of them.

To the question What have been the benefits of your stuttering? he wrote: “Comfortable and no need to change, expectations well known and can be predicted, excuse for avoiding responsibilities of life, successes in life a result of compensation for stuttering, stuttering generates a ‘sympathy vote’ in motivating people to act as you want them to, generates a ‘hero complex’; having succeeded in life in spite of a major handicap, makes people like you and want to help you, provides convenient excuse for not having achieved more in life.”

“Excuse for avoiding responsibilities in life” generated some questions that asked him to think of examples of responsibilities he’s avoided. Very often, this discussion enables the client to realize that he/she really no longer wants to use stuttering as a reason to avoid responsibilities…..when they become clear about exactly what those responsibilities are, they don’t seem so overwhelming, unattainable or scary.

To the question What might be the downside to being a more fluent speaker? Is there anything you’re giving up? he wrote: “people will expect much more of me, will no longer have stuttering as an excuse for my failures, will lose some motivation for proving myself and won’t work as hard to achieve, might become arrogant.”

Again, questions are generated and these issues are processed. For example, for: “People will expect more from me” , I would ask him to name names...who will expect more of you? What do you think will they expect? This then often generates a discussion about family and friends and helping the client to appreciate the need for educating everyone around create a supportive environment and to appreciate the process of change and the challenges this may entail….that they are “ a work in progress”.

“Might become arrogant”. I’ve had other clients give similar responses...that somehow with greater fluency they believe they’ll lose their sensitivity. So the question is “why do you believe that?” Typically, they realize that they won’t all of a sudden become a different person and that they can make any changes that they want to.

To the fourth question, What are the benefits of speaking more fluently? he wrote: “improved self image, more efficient in moving through life, on-the-job advancement and rewards, being a more open and loving person, greater internal peace and happiness, greater ability to meaningfully contribute to society.” Ron has some significant things here but the reasons for change seem to be less than the reasons for maintaining the status quo.

The critical information that Ron revealed to himself was that he was gaining far more from his stuttering than he had ever realized and, that these gains far outweighed any imagined benefits that fluency might have for him. This, then revealed the answers to why he was having difficulty concentrating and learning management skills!

There was an enormous internal conflict occurring on an unconscious level...”I think I want this, no I don’t...I think I want this, no, I don’t...”. He’d be on, he’d be off...his focus would be there and then he’d lose it. Some might call it approach/avoidance.

He had “worn” his stuttering for his entire life as a sort of “badge”, a badge that said “see how much I have accomplished in my life in spite of a major handicap!” It had been a source of pride for him. It was ego strength for him...a base to his identity. Also, his stuttering had allowed him room for failure; it was always there to point to as a reason for things not going as planned. He also realized he had enjoyed the sympathy and attention it garnered.

Fluency, on the other hand did offer him a certain freedoms but it also brought with it more responsibility and discipline. On some level, it just didn’t seem worth it to work all that hard. So, again, we now had some answers for the difficulty with his concentration and focus.
Once Ron had become aware of some of these more subtle dynamics at play, we then worked together to process them. With guidance, he was able to begin to clarify these issues for himself, weigh their importance and make some decisions. He was now able to appreciate the role his stuttering had played in his life and now could make some well informed decisions about changing that aspect of himself or not.

He continued this process over a couple of years...doing a lot of self exploration as well as some formal psychotherapy. He returned to me for a few full day sessions and we spent most of the days processing and dialoguing through these issues.

I can tell you with certainty that had we not gone through this process during his initial intensive, Ron would have relapsed fairly quickly; the benefits of stuttering weighing in more heavily than the gains from effectively managing his speech. And he would have likely experienced it as yet another failure and probably would have given up.

Instead, he left the intensive armed with information and feedback about what next steps to take to continue in his process toward recovery, with an optimistic and hopeful attitude. He knew he was being supported in a non judgmental way and that he had all the time and freedom to explore these issues for himself.

What Ron ultimately discovered was that if he really wanted to go after making a change in his speech, for example, he needed to find other ways to strengthen his ego and pride, perhaps in displaying the accomplishment of overcoming his stuttering. He had to find other ways of handling his “failures” so that he would no longer need his stuttering to point to. He needed to decide if he really wanted the sympathy that he felt his stuttering garnered and make other choices of how he might want to appear to others and/or receive his nurturing.

I received a call from Ron about two years after his initial intensive. He spoke freely and clearly and told me that he had decided to go back to work on developing his speech skills; that he was just tired of the stuttering . He had decided that he no longer needed it.

Let me share with you two other examples. Gene came into this program without many issues, as you can see by his answers to the questions. I just recently saw Gene and he continues to manage his speech quite well.

1) What’s bad about stuttering?
• Inability to communicate
• embarrassment
• fear of speaking
• avoidance of social interactions

2) Benefits of stuttering
• none
3) Downside to fluency
• none

4 ) Benefits of greater fluency
• confidence in speaking situations
• feeling of control
• ability to communicate effectively
• can handle high pressure situations

One more who was so very interesting: David. David was 17 and was brought from Florida to the intensive by his father. I had not had the opportunity to meet with the family prior to treatment, although I had done an intake over the phone and David indicated that he was ready to work on his speech. David was affable but quiet and mostly kept to himself. His dysfluency was quite severe. Like Ron, his work was inconsistent though it was more an issue of interest rather than focus. He would seem very interested in what he was doing for awhile and fully participate with everyone and then he seemed to become bored. Instead of practicing with the other clients, he read magazines. Let’s look at David’s answers to the four questions:

1) What’s bad about stuttering?
• it makes my body tight
• sometimes I don’t talk to my friends

2) Benefits of stuttering
• I don’t have to talk to my parents
• I don’t have to go to social events
with my parents (i.e. church events)

3) Downside to greater fluency
• I would have to talk to my parents
• I would have to go to social events (church) with my parents

4) Benefits of greater fluency
• None

Clearly, David wasn’t ready to change. Nearing the end of his intensive, I asked David if he minded sharing his lists with his father and he agreed to. His father sat quietly and listened. He and David then had a long talk as I listened. As David walked out of the room, his father said to me with a tear in his eye, ”that’s the longest conversation I’ve had with my son in five years.” My recommendation was that the family seek counseling. This was the gift in David’s coming to the intensive; to have that conversation with his Dad and to highlight this family’s need for counseling. And, perhaps in the future, David will decide that he wants to work on his stuttering and will know that there is help.
In summary, here are what I see as the intentions of this exploratory process:

• to validate the client’s feelings and attitudes about how stuttering has
affected his/her life in a negative way
• to enable the client to become aware of how his/her stuttering has
been beneficial
• to find alternatives to providing those same benefits if necessary
• to enable the client to be clear about the potentially “negative”
consequences to becoming a more fluent it OK to
make this change?
• to enable the client to be clear about his/her reasons and motivation
for change
• to create a vision for change

It is with the fourth question that my clients develop a focused list of the benefits of making this change. We transform the list into affirming statements which can be used as part of speech practice or daily meditation that will affirm and strengthen his process of change. I also ask that he choose what’s most important to him: what quality or attitude does he want the most in his life? I then ask him to visualize himself having this quality or being this way ( for example, confidence in a speaking situation) in at least 2 situations...perhaps one social and one at work/school. This is then anchored in writing and serves as his vision, his goal.

He has now gotten clearer on why he came to treatment in the first place. This is his basis of motivation.The Olympic athlete’s vision is seeing himself winning the gold medal and this vision serves as his basis for every decision he makes in his life...what to eat, when to get up, who he socializes with, etc. The desire to have this reality causes him to make certain choices.

I encourage my clients to use these images as reminders to make the decisions and choices moment to moment in their lives that cause their behaviors to move in the direction of creating that vision. For example, making time to practice, choosing to have the courage to manage skills in a new situation when it is tempting to go the “old” way and just get through the situation, self-advertise,etc. As long as the desire is strong enough and the vision is clear, this will increase the odds of successful managment in this speaking situation. Each success, then builds upon...

It is only through these revelations and the process of exploration that I believe some of these “roadblocks to recovery” can be removed in a treatment process. This, then opens the way for the client to more freely embark upon his new path of embodying his newly learned motor skills and attitudes.

added with permission, November 24, 2004