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Mastering Blocking & Stuttering: A Cognitive Approach to Achieving Fluency

"If you can speak fluently in just one context, you can learn to speak fluently in all contexts."

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Articles by Tim Mackesey

My Tangled Tongue

January 30, 2011 by Bobby G. Bodenhamer

– A Testimony by Walter Sturdivant Client of Tim Mackesey.

Walter Sturdivant

At around the age of four or five my mother told me to speak “low and slow.”  I wasn’t at all sure why I should do this and simply ignored the request.  It wasn’t until I was in the second grade that my normal routine of walking home from school with a friend was interrupted twice a week on those afternoons.  My mother took me to a speech therapy clinic where I sat at a table with a few other children who stuttered and literally blew out candles.  The words “when,” “why,” “where,” “who” were elongated so that if one of us extinguished four candles he or she was complimented and given a prize.

As these sessions progressed and as I continued to hear promptings from my parents to speak more slowly, no doubt my sub-conscious began to whisper to my conscious that I was not talking very well and that I must try harder to talk better.  Quite possibly I was “learning” how to stutter, or I was one of the children Dr. Wendell Johnson referred to when he said, “Parents teach their children to stutter when they teach them to fear speech by being ashamed at their best attempts at speaking.”

For me the key word in this statement is fear.  During my elementary school years I accepted stuttering as simply part of my personality, unaware that within some pocket of the left side of my brain fear was breeding.  When I entered a New England preparatory school I was teased not only about my Southern accent but also for my stuttering.  Some of my classmates believed southerners were poorly educated and that one who stuttered was, most probably, stupid.  For the first time, I found myself substituting a synonym for a word that usually gave me trouble.  In the vernacular of speech pathology I had “anticipatory anxiety” which is a result of stuttering and not the cause.  I would have a decent thought composed, but within it lurked a feared word.  Generally, I would not raise my hand in class to answer the question correctly, nor would I say exactly what I desired during social conversations. Ironically, because I was a mild stutterer (though with occasionally severe blocks), I was teased more often than those who stuttered severely.  I never accepted this attitude.  The most egregious example of this treatment occurred when a teacher imitated my stuttering in front of the class after I had answered a question.

At my school all graduating seniors were required to make a speech on a topic of their choice to the entire student body and faculty.  As weeks shriveled to mere days before the dreaded event, I began to feel dissociated from sports and other usually pleasant activities.  I felt adrift and believed that I would somehow be spared the ordeal.  Yet a speech was required for graduation and I was definitely ready to leave New England.

When I began to speak behind the lectern I oddly felt that I was hearing someone else’s voice.  The words came acceptably and continued fluently throughout the talk.  Afterwards, the English teacher in charge of public speaking told me that I did all right but spoke in a monotone.  Perhaps this slight alteration in my delivery enabled fluency as when the person who stutters sings, whispers or speaks loudly stuttering diminishes.

This victory soon dissipated when I became increasingly concerned about my freshman year at the University of North Carolina.  There would be social events, visits to fraternities and most probably trips here and there with “the boys”.  I asked my parents what could be done about my speech and my mother was told that the best clinic in the country at that time (1954) was at the University of Iowa, directed by Dr. Wendell Johnson.

There were about 10 of us sitting in a room not saying a word when Dr. Johnson, a jovial, portly fellow, entered.  He introduced himself by gently repeating the initial syllable of every word.  I was astounded and dismayed, sensing that this fellow had to be joking and was he even possibly mocking us?  He asked everyone to say our name and hometown.  When my turn came I spoke without hesitation and fluently.  Dr. Johnson looked at me suspiciously as did a few others.

That afternoon, he asked my parents why was I here, since he did not experience me stuttering.  Only years later did I conclude how unprofessional to initially judge someone who merely had a moment of fluency.  At that time I was still having moderate to severe blocks.

My therapist and I visited public places such as grocery, hardware, drug stores and restaurants where I practiced the gentle repetition of initial sounds in asking for an item or ordering a meal.  To my astonishment my listener did not look past me, smirk or say the word for me.  I was treated as a normal, fluent person.  As I progressed with this exercise my sub-conscious no doubt began to realize that my old stutter with tension was being replaced with a repetition lacking tension.  I sensed an emerging control over my speech that had never been present before.  Moreover, these speaking events in public places helped desensitize stuttering and lessen the anxiety of certain sounds.

While at Iowa, I came to know a medical student whose severe stutter had so depressed him that he was convinced he would never become a surgeon.  To ask fluently for the proper instrument during an operation was overwhelming.  While it is highly likely that Dr. Johnson’s methods enabled this aspiring doctor to gain more control over his speech, the stutter that remained most probably deterred him from pursuing a career in medicine.  He is typical of many talented people who stutter, in that they tend to turn inward and settle for the mediocre.

Whatever happened to me in Iowa was, as I reflect upon it, a wondrous oddity in that not only was I completely fluent, I did not seem particularly impressed about such an achievement.  Moreover, the only ‘A’ I received at the University of North Carolina was, ironically, in public speaking!  During my senior year a friend told me that I had an “irregular” speech pattern.  Apparently I paused between words, or spoke quickly, hesitated then resumed.  As an officer in the Marine Corps I had to speak before troops, and, occasionally, before an audience in an assembly room.  Was I a miracle in the making?  Hardly.

During the early sixties in a north Georgia rural town I became the editor and reporter of a weekly newspaper.  Whereas the position strengthen my ego, the unrelenting pressure of producing a 6 to 12 page journal with the assistance of only a secretary began to test my resolve.  I shall always remember a significant moment that occurred one afternoon.  While speaking over the telephone, my stutter so rudely returned that, initially, I discredited its substance, merely attributing the moment to an absurdity resulting from fatigue.  Yet on following days when using the telephone, my foe returned with conviction and, as I would discover throughout the remainder of my professional career, it would remain permanent.

During the early seventies I attended a speech clinic on the Hollins College campus in Roanoke, Virginia.  The method was based the theory that we speak the way we hear, and that if the inner ear senses disruption then stuttering would ensue.  However, if the ear hears a soothing rhythm, fluency would result.  The three-week program known as “fluency shaping” consisted of dramatically stretching words liiiiiiiike thiiiiiis.  During the second week stretching was reduced, and in the final week normal fluency was attempted and nearly everyone succeeded.  But for me, and I dare say for many of the others, the experience was merely a temporary fix not only because we never ventured into the city and spoke in public places, we were merely attempting to manage symptoms and not digging deeper into the psyche.

I abandoned therapy until the late eighties when a female therapist believed that my speech would improve if I practiced optimal voicing of vowels by keeping the shape of the oral cavity ready for the vowel only and to breathe through the abdomen.  So I would drive around in the car saying, “pAy”, “kEy”, “pUt”, “tOp”, feeling, indeed, like there’s no fool like an old fool.  Although some sounds became more manageable I was concluding that I would always stutter.

As the 21st Century dawned, and as I began to feel my seniority deepen, stuttering became more an annoyance rather than an embarrassment.  Why was I fluent in most speaking situations except the telephone?  Was there anything more I could do here in Atlanta, as the thought of traveling to yet another disappointing clinic was hardly appealing?

When telling my story to a group of speech pathology students at Georgia State University in July 2004 Tim Mackesey’s name was mentioned and his Neuro Linguistic Programming (NLP) was briefly discussed.  What caught my attention were the cognitive or emotional issues that he confronted.

In August I had my initial interview with Tim, was sufficiently impressed with his approach and therapy began.

We initially revisited specific moments in my past when I had encountered severe blocks either on the telephone or in mixed company.  We “edited movies” of these events so that they became insignificant and anxiety-free.  Then I learned that stuttering followed a 1-2-3 pattern:  1) I would sense a “feared” word approaching that set off…2) anticipatory anxiety in my throat or chest that would pose the…3) fight/flight option, meaning that I would either inhale then stutter through the word or simply substitute words (flight).

To successfully reduce initial anxiety as the stuttering moment approached, I learned that the thought of experiencing a feared sound (plosive or fricative for me) precedes the anxious feeling and the anxious feeling precedes the actual stutter.  I learned that the initial fear, the thought that I was going to stutter, could be significantly reduced by knowing I had a way to “re-frame” the moment—that being to welcome the feeling, exhale and let the word slide out.  Also, pausing before initiating the sound often helped to deliver the word fluently.  Since option 3) was no longer valid, I concentrated on 1) and 2) and began to realize that the plosives and fricatives that had for so long plagued me were actually harmless.  Hence, the old panic began to wane and I became increasingly aware that I could control them by this new approach in “managing my state”.  Most important, I realized the therapy taught at Iowa and at the Hollins campus treated only the symptom—the moment at which the stutter occurred.

State Management requires dedication but, at least for me, I am convinced that this therapy is the answer, and that I can reverse the “mind-to-muscle” idea that I stutter.  That I can become fluent in all speaking situations all the time is now a distinct a reality.  I have been having more victories on the telephone and those once troublesome sounds, now free of tension, are “anchored” in my subconscious.

What causes stuttering and why it persists into adulthood is still debatable. Yet I sincerely believe that, at last, permanent relief from this most embarrassing, and humiliating affliction is possible through NLP methodology.

Finally, for me, the winner’s circle where fluency is commonplace is no longer a mirage.  Its clarity strengthens daily and during this year I shall return to that fluent person I once was – that child who never doubted the first sounds he made.

Note: I very much appreciate Walter’s telling us his story with NLP and Neuro-Semantics.  The viability of any new model is that other people with similar knowledge can take the new model and duplicate its findings.  With Walter’s story we see the results of speech pathologist Tim Mackesey, SLP of Stuttering Specialists in Atlanta Georgia. Indeed has utilized these tools in assisting several clients to much more fluency.  There are others in the Neuro-Semantic Community obtaining the same results thus validating this model for PWS.

Filed Under: Articles by Tim Mackesey

The Swish Pattern

January 30, 2011 by Bobby G. Bodenhamer

by Tim Mackesey, SLP

Pour la traduction française, cliquez ici (PDF)

Purpose

To move from an unresourceful state to a resourceful state instantly. To “break state.”

If you are experiencing anticipatory anxiety before speaking, swish away the feeling quickly.  If you have negative feelings after a stutter, prevent a new somatic memory on your time-line.  The swish pattern is a powerful tool- when combined with reframing and the Drop-Down Through pattern- to help become “relapse-proof.”

Where there are many versions of the swish pattern in NLP, this is my favorite.  Why?  The fast, kinesthetic movements of the hands complement the visual and auditory experience.  As you see and feel the toxic state on the back of your right hand, you bring it closer to your face and welcome the feelings intensifying.  When you are fed up of this feeling and image, you do a quick motor movement of your hands while saying “swish.”

Hence, this version of the swish pattern incorporates V-A-K: Visual, Kinesthetic, and Auditory channels.  Some people pick a word such as “fluent,” or “confident” in place of “swish.”  Make sure you say a word when doing the arm movements.

Application

When anxious, angry, nervous, or any other toxic unresourceful state.  Why stay in a bad mood when you can change instantly?  Break state !!

Process

  1. Identify the mood/feeling and put in on the back of your right hand.  Feel and see a memory of that toxic state.  As you bring the hand closer it intensifies the negative feelings.
  2. Shake that off and break state.  It is critical to clear your head before #3.
  3. What state do you want to be in?  What is opposite of the toxic state?  Recall a time when you were in that ideal state….imagine it intensely…..see, hear, and feel what that is like….breath the way you did, now.  When you have it amplified to a 10/10, put it on the back of your left hand.  This is your positive anchor.  A ring band is a great visual target.  As you bring the hand close you feel better- great.
  4. Shake it off and break state.
  5. Put your right hand out in front of you and as you bring it in the negative feeling will intensify.  Just let your self experience it, as it is only a feeling.  Get your left hand into position in front of you with arm fully extended; just left of center.  So now you have the right hand “in your face” close and the left hand at full extension.  Your are now loaded and ready for action!  As you say the word “swish,” rapidly push your right arm out to full extension and bring the left/positive hand in real close.  With the left hand close, recall the positive state intensely.  The arm movement is to be done rapidly and with intense feelings.
  6. Shake it off and break state.
  7. Test: look at your right hand.  Is there still some negative feeling left?  If it is gone, great.  If not, repeat exercise as many times as you need until the looking at the right hand is completely emotionally neutral.  You should be able to say “It’s gone.”  Congrats !!  You used the swish pattern to run your brain and change your break state instantly.

When you realize that you now have a tool to immediately change your mood, how will that change your future?  What will become easier?  When and where do you imagine using it in the days and weeks to come?

In the future, use your left hand, and the positive anchor, to step into a resourceful mood when you desire. “Stacking the anchor” means to recall new, great experiences on that anchor point.  As you bring the left hand up and you focus on the anchor point (i.e., ring band), it will “fire off the anchor” and put you into a resourceful state.  So, after each positive, new experience you will want to re-associate into that great memory, amplify it to 10/10, and then open your eyes and see it on the left/hand positive anchor point.  How bright will your future time-line be?  Public speakers, athletes, actors, and others who seek peak performance use this technology.

Author

Tim Mackesey, PC, CCC-SLP
770-399-5455
1874 Independence Square
Suite B
Dunwoody, GA 30388
fluency@bellsouth.net
www.stuttering-specialist.com

Filed Under: Articles by Tim Mackesey

There is Much More than Meets the Eye Contact

January 30, 2011 by Bobby G. Bodenhamer

Tim Mackesey, SLP

Pour la traduction française, cliquez ici (PDF)

Eye aversion, or intentional breaking of eye contact during moments of stuttering, is more than meets the eye.  It is far more than just a behavior. To fully understand eye aversion it is important to examine it from several angles.  These include: 1) defining appropriate eye contact, 2) the positive intention behind eye aversion, 3) the cognitive and emotional aspects of eye aversion, 4) the listener’s perception of eye aversion.

First we must attempt to define appropriate eye contact.  In language there is a system called pragmatics. Pragmatics is the language system that governs socially appropriate nonverbal and verbal language.  This includes, but is not limited to, body posture, turn taking, ‘politeness,’ and eye contact.  Appropriate eye contact does not mean staring like a deer in headlights into your listener’s eyes.  In fact that is impossible because humans follow a distinct pattern of eye accessing cues as they retrieve and/or formulate information.  For example, a right handed person will look up and left when accessing pictures, look up and to the right when creating pictures, look down when accessing emotions, and look left and right respectively when accessing or creating dialogue (words)*.  So, there is natural and necessary eye movement when conversing.  If you stutter, or provide services to those who do, you know how to recognize eye aversion.

There is a relatively consistent positive intention behind eye aversion.  Stuttering therapy pioneer, Dean Williams, wrote about positive intentions behind many stuttering behaviors.**  No one was born eye averting. Eye aversion is not a neurological tic (uncontrollable bodily movement).  Eye aversion is a voluntary action programmed and conditioned subconsciously. Eye aversion is provoked by a combination of cognitions (limiting thoughts) and limiting beliefs about listener reaction.

People who stutter may be attempting to protect themselves from seeing a listener reaction.  If so, they are mind reading, or presuming to know the reaction of the listener.  It is often associated with guilt and shame over one’s stuttering.   Stern correction by adults, teasing, bullying, and other negative experiences when young may help explain the foundation for the habit of eye aversion. The term “foundation” is used to imply these experiences are the references for the cognitions and emotions; the beliefs that stuttering is “bad,” “unacceptable,” “not tolerated,” and so on.  It is when a child attaches a stigma to the behavior of stuttering that cognitions and limiting beliefs take root.  I have seen eye aversion in children 3 years old to adults in their 70’s (older cases surely exist).   Young children need help in modifying the behavior. Adolescents through adults have to take ownership over the behavior in order to integrate new patterns of communication and fluency.

There is a mind and body connection in stuttering.  For instance a person may anticipate a stutter on the word “contact,” look away from his listener, tense his tongue against the roof of his mouth and utter “c-c-c-contact.”  Often that just isn’t enough.  He may then replay the moment of stuttering, feel guilty, mind read, and question his ability to say the word “contact” next time.

I recently interviewed a 41 year-old attorney who stutters.  The dialogue was as follows:

TM: “…I notice that you look away each time you stutter.  Is that something you have been doing for some time?

BB: “Yes, come to think of it I do it all the time.”

TM: “How do you know when to look away?”

BB: “I get embarrassed”

TM: “How do you manage to get embarrassed when you stutter?”

BB:  “I wonder what they are thinking about me?”  (mindreading)

TM: “Please fill in the blank for me.  If people see or hear me stutter they think

(blank)?”

BB:  “I am inadequate”  (limiting belief)

TM:  mirroring comment “You think you’re inadequate”

BB:  shrug “Yes… I guess I have been thinking that.”

TM:  “Has that served you well?”

BB:  “Definitely not!”

It is here that I modeled two ways of stuttering on my name.  I asked him to watch both examples and tell me which way made him feel more comfortable.  First, I looked directly into his eyes and said: “My name is T-T-T-T-T-T-im” with visible tension in my mouth.  Second, I kept eye contact for “My name is” and then averted eye contact for “T-T-T-Tim.”  (The actual stutter in the mouth was made as identical as possible.)  When asked which made him more comfortable he was adamant that the example with eye contact made him more comfortable.  He went on the say it made him more comfortable when I stuttered with eye contact.  When asked what he thought of me as I looked away, he answered “afraid.”  Afraid, uncomfortable, and scared are the typical answers I hear in this exercise. That experiential exercise helps people who stutter decide that they want to keep eye contact. It is one thing to intellectually understand the importance of eye contact.  It is entirely different to emotionally commit to it.

Eye aversion can have a profound impact on a relationship.  For example, I recently facilitated a family counseling session involving an 18-year old male with a severe stutter and his parents.  When asked the positive intention of looking away while stuttering, the 18-year old replied: “I think I’m bothering them when I block…it takes so long for me to get the word out….sometimes I just say ‘forget it’ and walk away.”  His  parents reported that they also always looked away.  When asked their positive intention for looking away, they replied: “We thought it would be easier on him…less pressure…we just wanted to help.”  Can you see the communicative wall that was built between child and parents?  It happened that the young man had his most severe and chronic stuttering around his parents.  They all committed to keeping eye contact during moments of stuttering modification.  They noticed an improvement in fluency and a much more healthy relationship in a couple days.  Eye aversion makes the listener less comfortable and makes the stuttering appear like more of an impediment.  It is a lose-lose habit.

Eye aversion’s cognitive and affective phenomenon can be examined in another way.  A pragmatically correct and comfortable conversation would involve appropriate eye contact.  When a person uses eye aversion they are intermittently disassociated from the conversation.  Specifically, as they look away they mind read, physically tense, and stutter- they intensify the stuttering state.  Charles Van Riper once said: “Stuttering is everything you do trying not to stutter.”  Eye aversion is an avoidance strategy– trying not to stutter and not be identified as a “stutterer.”  Stuttering severity, anxiety, and physical tension all increase during eye aversion.  People who stutter initially think it helps- that is until they experience the contrast of direct eye contact.  Staying relaxed and confident is a prerequisite to utilizing any fluency shaping or fluency modification strategies.  One must intentionally keep eye contact during the anticipation or realization of stuttering.  That way the speaker is associated, present, and in the “here and now.”   One must build his mental acuity to identify the urge to avert the eyes, and then make a commitment to make eye contact and go forward into the word.  This commitment would, of course, disallow any use of interjections (i.e., “uh,” “um”) or any filler words before the feared word.  If you want to swim, you must get into the water.

Telephoning is another situation where eye aversion can be evaluated.  Using a mirror, people who stutter can face themselves during a phone call.  If they avert eye contact with themselves during stuttering, similar cognitions and limiting beliefs exist.  The positive intention of eye aversion is to protect oneself from confronting the reality that he is stuttering.  Fear of stuttering and shame are at work in that moment.  Purposeful eye contact in the mirror during stuttering modification can rapidly desensitize people who stutter to the behavior of stuttering.  Voluntary stuttering while making eye contact, in face-to-face conversation or making phone calls, can be helpful in expediting desensitization.

Regardless of the variety of speech therapy strategies employed or favored by the individual who stutters, success is dependent on being associated with the listener.  This requires a commitment to purposeful eye contact when stuttering is anticipated or experienced.

In summary, people who stutter (pws) are to recognize that it is vital to maintain eye contact at the moment of stuttering anticipation or realization.  There was a positive intention behind eye aversion when the person who stutters was younger (to protect oneself from possible listener reaction), and that to move on one must have a new positive intention– to be associated, confront fear, and gain freedom speaking.  One must experience that eye contact is a prerequisite to the ability to elicit a state of confidence and relaxation.  Therefore, success with fluency strategies is positively contingent on keeping eye contact.  Beliefs and cognitions to replace the old, limiting ones could include: self-acceptance, feeling safe and secure using purposeful eye contact, feeling worthy as a speaker, believing that listeners will approve of eye contact during stuttering and/or stuttering modification, and that disfluency of speech is tolerated by others.  Realizing that eye aversion is a rapport breaker and that purposeful eye contact is a win-win habit- it makes speaker and listener more comfortable.

Tim Mackesey, CCC-SLP (Published in Perspectives on Fluency and Fluency Disorders, April, 2002)

*   Brooks, Michael.  Instant Rapport (Warner Books, 1989)

** Williams, D.E. (1957). A Point of View About Stuttering. JSHD, 22, 3, 390-397

Addendum to article for those applying the Drop-Down Through (DDT) process:

It is essential that a pws stop averting eye contact when anticipating stuttering.  The frames that drive aversion are consistent with away-from motivation; trying to not stutter and not be noticed as a person who stutters.  These are very toxic frames to overcoming stuttering.  The meta-state during eye contact aversion is not consistent with the meta-state that accesses fluency freedom.

Having said that, there are moments in the DDT when looking in a quadrant to access the highest resource will require looking away.  For example, one client looked up and left for a millisecond to access a visual image of his highest resource- which happened to be spiritual.  When first using the DDT, some pws will close their eyes and “go inside” as they DDT.   This is entirely different than looking away from the fear of possible listener reaction.  The intention of the DDT is to release anticipatory anxiety and utter fluent speech.  If a pws felt the urge to avert eye contact, I would encourage them to intentionally hold eye contact for a split second before utilizing the DDT.

In regards to accessing a highest resource or pausing to use the DDT, who will set the rules about pausing?  The pws better set the frames.

Author

Tim Mackesey, PC, CCC-SLP
770-399-5455
1874 Independence Square
Suite B
Dunwoody, GA 30388
fluency@bellsouth.net
www.stuttering-specialist.com

Filed Under: Articles by Tim Mackesey

Straight Talk on Portable DAF: SpeechEasy and FluencyMaster

January 30, 2011 by Bobby G. Bodenhamer

Tim Mackesey, SLP

Background:
The makers of the SpeechEasy (SE) have enjoyed a recent splash of free publicity by appearing on Good Morning America, Oprah, and write-ups in some magazines. The SE’s most immediate predecessor, the FluencyMaster (FM), has been on the market since 1989. Good Morning America, featuring the SE, had the subtitle “An End to Stuttering.” Oprah had a subtitle across the screen stating “Stuttering Stopped by the SpeechEasy.” That would presuppose that users of the SE would stop stuttering in all situations, wouldn’t it? So, just put it in and become fluent — simple as that. A quick visit to your internet search engine will result in you seeing marketing claims for these devices with teasers such as “Stop Stuttering now.” Wow! I guess that is why speech clinics around the country have been bombarded by inquiries about these prosthetic devices. Family and friends of the afflicted are calling to share the news, and/or offering to buy one. The notion of a quick fix is mighty alluring. The FM has returned to the spotlight and been pulled onto the coat tails of the SE story.

The Skinny:
By attending to your own voice via an auditory feedback appliance in one ear, it may slow your rate. The SE attempts to simulate choral reading — when someone reads in unison — which has been known to induce enhanced fluency in the clinical environment. For example, PET scan studies of the brain use induced fluency by choral reading to get a “fluent” sample to compare to a stuttered sample.

There are people benefiting by these devices in some situations and I applaud that. Several people reported that the severity struggle of the stuttering blocks was reduced somewhat (Accurate measurement would, of course, require measuring severity in multiple speaking situations over 12 months or more.) I have had some clients do a trial with them. I am happy for anyone getting some relief with electronic devices.

After interviewing several people who own, or have returned, these above devices.
Anyone considering buying one will want to consider the following limitations:

  1. Ambient noise (i.e., restaurant, bar, cafeteria, shopping mall, etc.) may render it useless. The user must be able to listen to the signal (their voice) in one ear. Take it out of the clinic into a noisy environment and “test drive it.”
  2. Phone. Many people report that hearing their own voice delayed in one ear and listening to someone else on the phone is overwhelming. Make a call with it. Then make a call with it that you expect to stutter on. Does it serve you as desired on the phone?
  3. One complaint I have heard specific to the SE is that the speaker hears his own voice, and other voices, altered to sound either higher in pitch (reported to sound like a chipmunk), or lower (reported to sound like Darth Vader.) Many have reported that to be annoying on the phone and off the phone.
  4. Blocking. The devices require hearing oneself. If you produce silent blocks, you may want to explore this. Some soft sounds like /h/ can be a challenge.
  5. Anxiety. Test it under your feared speaking situations. Can you benefit from it when you need it the most? Does anxiety overwhelm the ability to attend to the signal? If phone calling has been a feared situation for you in the past, it may further increase the difficulty of attending to the auditory signal. Again, put the device to the test.Based on helping several hundred people who stutter in therapy, and recovering from it myself, I strongly believe that anticipatory anxiety will prove to be the pivotal factor for which the electronic devices will never compensate.
  6. Will you be comfortable seen with it? If you are self-conscious about stuttering and would be sensitive to inquiries about it, consider this. I only mention this because it has been cited by a number of people who stutter. One 33 year old had been telling people he was hearing impaired. Another said: “…It was like letting my ‘flaw’ hang out there for everyone to see.” Obviously, these people are not good candidates, are they?

I personally desire all people who stutter to get their break-through. Since these limitations were inadvertently left out of the reporting, I feel obliged to help people make an informed decision. I personally hope that the manufacturer of the SE asserts itself better in the stories about the devices- to include limitations. If you “stress test” one of these devices, and its performance is consistent with what you expected and find worthy of the price, go for it. I mean that.

The homepage of the Stuttering Foundation of America, a recognized authority, provides good insight about portable devices. The SFA’s 2004 survey, available on-line at www.stutteringhelp.org/research/survrslt.htm reported that less than half of the owners of these devices are happy six months after purchase. You might also want to get into a chat room for people who stutter and pose questions to others who have done a trial with portable devices.

I recommend careful consideration before fitting a young child with one of these prosthetic devices. The belief they inherit is that they must rely on an external aid for help. I recommend speech therapy with a specialist to help the child manage the disfluency and cope with emotions when they stutter in the situations where the device fails them. Some marketers have compared electronic devices to eyeglasses for the visually impaired. This is, at best, an awkward comparison. A good prescription works when you read at home, school, on a plane, on a bus, inside, outside, and everywhere there is adequate light. However, there are many situations in which electronic devices will not stop stuttering and not provide fluency.

Considering the significant price of these devices, will parents mandate use of them? I have already mediated family-child debates over mandatory use when the child refused to wear one. SLP’s have always advised parents to refrain from badgering and correcting a child who stutters. layering guilt and shame on a child for not wearing on could backfire bigtime. The whole process of nurturing and supporting a child who stutters must be considered before prescribing portable devices.

It is interesting to point out that the FM has had a recent surge in sales. A colleague of mine, who dispenses the FM, said this: “…people heard about the SE and started investigating DAF…when they begin comparison shopping they may choose the FM (about $3,500) over the SE ($3,600 – $5,000).” Both require an ear mold made by an audiologist. Both offer a 30-day trial. Returns forfeit the fitting fee. Check with the manufacturers for exact prices and return policies.

Wisely, both manufacturers report that they recommend speech therapy to support use of the device. Be advised: these devices are not a quick cure. Perhaps a famous quote will summarize truly overcoming stuttering: “He who would have the fruit must climb the tree.” Stuttering symptoms may be reduced in some contexts with the aid of these devices. However, the speaker will have to work very hard for a breakthrough.

© 2003 Tim Mackesey CCC-SLP, BRSFD/Mentor
Revised June 2004
Please request permission to quote or reproduce this article by sending an E-mail.

Author

Tim Mackesey, PC, CCC-SLP
770-399-5455
1874 Independence Square
Suite B
Dunwoody, GA 30388
fluency@bellsouth.net
www.stuttering-specialist.com

Filed Under: Articles by Tim Mackesey

Freedom of Speech: How I Overcame Stuttering

January 30, 2011 by Bobby G. Bodenhamer

Tim Mackesey, SLP

Boca

It’s the second week of my sophomore year in a college accounting class in Boca Raton, Florida, and I’m about to relive my worst nightmare. My professor has just announced that we will go down the rows of seats one after another taking turns reading the homework questions and giving our answer. I was in total panic. All my past memories of and embarrassment for reading aloud in class, from childhood to now, were all a cumulative horror.

The worst fear of my life was in front of me right now. I had to read. I could not leave the room. For many years I used to leave the room saying I had to go to the bathroom. As a result of fear, I would stutter while asking to flee. Here I was feeling like a naked, armorless knight cornered by a fire-breathing dragon.

I began to stutter on nearly every word. I was suffocating as my larynx tightened, and I created massive speech blocks. I noticed some of my classmates turned with an astonished look, as they had never heard me speak. They were probably very surprised. I had stayed silent in the class before that moment.

I left the class that day feeling defeated. I went to the admissions office and dropped the class. I lost a percentage of my tuition, but I gained leverage on myself to finally begin changing. That was it. I could not go on like this anymore.

Later that day I was in my room alone. I was reading aloud the very same text I had read earlier in class. I read totally fluently and totally at ease. I thought I sounded like a news correspondent, or actor. My voice was rich, my chest was relaxed, my tongue moved from sound to sound and syllable to syllable with ease and fluency. Was I hallucinating or was I really capable of speaking this way? I was in a different identity at the moment. This “alone identity” did not expect or know how to stutter. Then I got the idea to record myself. I went to push the record button, started reading it, and immediately started stuttering. I turned off the machine in disgust.

I can reflect back and make an association to telephone answering machines at the time. You see, for about a decade I had hung up instead of leaving messages on answering machines. Caller ID was not born yet. At the time, all I knew was that I was doing something to sabotage my speech. I believed that because I could speak with total ease in fluency when alone, that I was created perfectly by God. At that moment the pain was so great that I finally had leverage. I would reach my goal of effortless, block-free speech if it killed me.

“The journey begins within and it ends within.” — Sufi

At that time in my life, age 19, I lived with what Joseph Sheehan called the “giant in chains complex.” Like the giant in Gulliver’s Travels pinned to the ground by the tiny Lilliputians, I felt shackled by my stuttering. I blamed everything on my stuttering. For instance, the manager at the exclusive restaurant I was working had offered me a promotion from busboy to waiter on several occasions. I made up illogical excuses and deferred promotions each time. I would’ve gone from $50 a night in tips to about $200. Again, pain was applied to my stutter. I wasn’t dating much because I wouldn’t call any of the women I met. Not calling women was self-induced torture.

I have learned that when people finally take action they are either motivated by pain or pleasure; the pain of continuing to struggle as they are or the perceived pleasure of overcoming their obstacle. Like the proverbial mule that starves between two haystacks, I had been immobilized by indecision. I had refused speech therapy for many years. I was caught in the middle, suffering but not taking action. Ironically, it was in Boca, meaning “mouth” in Spanish, where I finally developed enough pain that I took action. Raton means “rat” in Spanish. Up until then, I felt I had a rodent living in my brain and in my mouth.

“Timmy, you stutter!”

Until second grade I had no idea there was anything different about my speech. I was a little blond hair, blue-eyed boy running through life. One day in elementary school we were planting seeds into little cups with dirt in them. Apparently I stuttered. My teacher took me by the wrist, led me into the hallway, closed the door, and in the privacy of the hallway looked down at me and said: “Timmy you stutter!” She had a look of concern and urgency on her face. I had never heard the word stutter before, but I knew it had to be bad based on her facial expressions and the inherent need to take me into the hallway to deliver the news.

I became her project. She began pushing me to talk more than the other children did. She assigned me the lead in a play called The Lincoln Pennies. I recall standing on the stage one day in our small auditorium and stuttering in front of all the parents of the children—including my mother. My teacher had good intentions. She wanted to help me. She, and anyone else I used to blame for my feelings about stuttering, have been completely forgiven — a crucial step towards healing. It was not her fault that I stuttered. There is a family history of stuttering on my paternal side. Even though my family does not recall any stuttering prior to that, maybe I had some age appropriate disfluency. Either way, it is of no benefit to look back.
Whatever this problem was that I had with my speech, it was apparently significant to others. I recall a very brief enrollment in speech therapy that was held in a utility closet at my elementary school. There was Tim, a mop, a bucket, some toys, and my speech teacher. I was discharged from speech therapy after a short while.

Earlier, in first grade, I loved being singled out for my accomplishments. Apparently my handwriting was good for my age. I was often asked to come to the front of the room and write on the chalkboard. Expressing myself brought me great pride. In third, fourth, and fifth grade I gradually began “acting out” more in classes. I chose to be a prankster and instigator as a form of expression. My stuttering remained about the same for the duration of elementary school.

I had several situations of blatant teasing and taunting in elementary school. One girl in particular was a frequent pain to me. After seeing how much she could anger me, she recruited some friends and choreographed a skit in which they put their hands on their hips, move from side to side and called me “stutter butt” in unison. One day I walked out of a class into the hallway and was greeted by them with their new dance routine. A number of people asked why I stuttered or imitated it. In hindsight, it is clear to me that my reaction to these experiences are the reasons why I started programming myself to prevent stuttering. Many years later I would learn Charles Van Riper’s famous quote: “Stuttering is everything we do trying not to stutter.”

Middle School

The first day of homeroom in sixth grade we sat in a circle and introduced ourselves. Across from me sat what I thought was the most beautiful girl I had ever seen. After spying her at orientation that summer, I thought I hit the lottery to have her in my homeroom. We were told to say our name and what we did the previous summer. I had been trying to flirt with her using my eyes. As my turn approached, I became very anxious and anticipated stuttering. When I started to stutter, she looked down, and when she looked back up at me, she had an uncomfortable smile. She now knew my secret. I tried to pretend like it didn’t happen. The number of events that involved stuttering—events that helped build my phobia around speaking—developed quickly in middle school. Reading out loud was my biggest nightmare until eighth grade. Oral presentations would soon be torturous, as well. The telephone became as painful as picking up a piece of hot charcoal.

Taking a principle or belief such as “I will protect myself from feeling embarrassment by avoiding speaking and using tricks”…and translating that into physical behaviors…is called mind-to-muscle, by cognitive psychologist L. Michael Hall. This physicalizing of my speaking fear manifested itself in such behaviors as eye contact aversion, word changing, avoiding, sitting low in my seat in class, hanging up instead of leaving phone messages, inserting “uh um” as filler words before stuttering, using character voices, speaking on expiratory reserve and raising the pitch of my voice, jerking my head down during blocks, and so on. Over time, these avoidance strategies evolved into automatic and unconscious habits. Every behavior had a positive intention at first but ultimately, did not serve me well at all!

By middle school I had begun associating fear with specific words. For instance, the name of our street was Yellowstone Drive. If people asked me what street I lived on, I could remember past experiences of stuttering on the word and would go into a panic. I remember calling for pizza delivery to our home and when they would ask the name of the street go into choking speech blocks. I would later name this mechanism inside the brain that can scan into the past and/or forward for feared words a Linguistic Search Engine (LSE).

I was back in speech therapy now. I was being helped by a lovely woman with good intentions. I was being told that if I said five words, took a new breath, and said five more words, I would stay smooth and fluent. One day before a planned oral presentation in class, I came to her with great concern. I shared my fear of stuttering. She said: “Don’t worry. Go in there, say your five words, take a breath, and five more words each breath and you’ll stay totally smooth.” I went to class that day, stood in front of the class, stuttered, and I was snickered at by several children. Speech therapy had lost credibility for me, and I convinced my parents to let me quit. They offered to take me to the local university clinic, but I refused. Little did I know that I would end up at that very clinic many years later to start exterminating the rats in my mouth and brain.

High School

Speech-wise, high school was a nightmare. I taught myself a myriad of strategies to avoid stuttering. In the classroom, I sat low in my seat, attempting to hide from teachers. I faked sick on days when I was to give an oral presentation. I negotiated a “D” grade for not doing an oral report in one class. Would you believe the teacher let me and did not call my parents? I take full responsibility for my cowardly choice, and at the same time, wonder what would have happened if he had convinced me to face my dragon?

I asked some teachers to excuse me from reading aloud. I substituted words, and avoided words so frequently that when I got done saying something, I would often be asked “What did you say?” Then I would end up stuttering through what I had originally intended to say. A very inefficient and frustrating way to communicate.

I did my best to avoid making any phone calls for nearly a decade. I sabotaged dating. I would ask a girl to “go with me” but then never call her. Sending these mixed signals, such as being nice at school but never calling, made the relationships short-lived. Confiding that I stuttered and was uncomfortable calling may have taken care of the whole problem. But I assigned great shame to my stuttering. I began mind reading my listeners, creating toxic thoughts such as “What would her mother think if she heard me stutter?” Some of the names of these girls continued to be feared words later in life.

We belonged to a country club at the time. Golf was my escape. Being a member of the club, I was entitled to make a tee-time by simply picking up the phone. Instead, I would ride my bike about 10 miles, put my name on a waiting list in the pro shop, and wait up to two hours before playing with people I often did not know. I would see other kids my age organizing foursomes and playing together on a routine basis. This self-induced outcast role was very painful.

The University of Wisconsin

Before going to Boca Raton I spent my freshman year at the University of Wisconsin in Madison. That year in the dormitory was a blur of drinking, stuttering, and learning that I did not know how to study. When drunk, I forgot about my stuttering and was more fluent—liquid fluency. My moving to Boca was intended to give me an opportunity to step away and reevaluate my life.

One of the first things I did upon returning to Madison in my third year of college was to go down to the speech and hearing clinic to inquire about speech therapy. The waiting list was more than a year. At the clinic I met Florence “Flo” Filley, the clinic supervisor. I felt that she could see into my soul— my stuttering soul, that is. I arranged a few private sessions with her before getting a phone call from the clinic.

Half way through my evaluation at the clinic, the graduate student said “Tim, we are not really hearing a lot of stuttering.” I knew this was a nice way of saying that I was changing words and avoiding too much. I replied, “Give me something to read.” When I started reading, the mask was off, and the monster came out of my mouth.

I had two semesters of speech therapy with graduate students at the clinic under the supervision of Flo. I started learning that I had some choices: I did not have to stutter the way I was stuttering, and I did not have to avoid the way I was avoiding. I made every appointment and was thirsty for knowledge. My covert avoidance was far from over though.

I recall praying in a church on campus. Between classes I would go in alone and cry in the front pew. I had initiated an inner turmoil by finally confronting my dragon—stuttering. It was breathing flames and daring me to raise my sword.

On speech “field trips” to a local shopping mall, my assignment was to stutter on purpose with store employees. When I did it, I would walk away from those sessions with a euphoric tingling in my stomach, knowing I just did what I feared the most. In retrospect, that very area around my abdomen I would later learn was ground zero for my anticipatory anxiety that precedes stuttering.

I took a job as a taxi driver. This proved to be one of the most powerful experiences of my life. Here I had the challenge of speaking to strangers in my cab and talking into the radio. I had established a hierarchy of fearful scenarios in my cab. Some of the worst speech blocks I have ever had were heard in the dispatch office of the taxi company as well as other drivers and employees. I started to fear saying certain street names and common pick up points. After several severe blocks on “hound,” I changed the word Greyhound into Graydog. Thinking it was cute, other drivers and dispatch adopted this new term for Greyhound. If people were in the car to hear me, I stuttered even worse into the radio.

I learned that changing street names was a problem. Henry Street is a major artery through the campus. One day I was called to give my location. I gave the name of an adjoining street to avoid saying the dreaded Henry; a wicked block-inducing word. Another driver passed me on Henry and when he heard me give a different street name he reported me for attempting to steal fares. In hindsight, I did not know where the fare was going to, hence I had no advantage in lying and reporting that I was about a block away from my actual location. Nevertheless, I was being dishonest with myself.

One day I was faced with the moment of truth. I had picked up three attractive sorority girls on Henry Street. In their presence I was to call in and report that I was picking up a fare on Henry Street and where I was going as a final destination. In speech therapy I had been practicing the traditional strategies of easy onsets. Easy onsets are done when initiating a word beginning with a vowel using soft, prolonged voicing.

It was show time! I decided that I was going to say it. I did my best to calm my racing mind and my panicked chest enough to use and easy onset into Henry. Little did these girls know that I equated the upcoming feat with making a 4 ft. putt to win the U.S. Open golf tournament in front of several million television viewers.

I started the word by emitting air through my larynx and stretching the /h/ sound for a couple seconds. When Henry Street came out of my mouth without a stutter, I wanted to park the car and begin a Mardi Gras-sized street party. That moment changed my life.

I could not wait to tell the folks at my next speech therapy session. That moment saying Henry Street without a stutter put me on the road to change. It showed me that I could control the monster in my mouth. If I was the giant in chains, then I had just started to break some of the shackles. Flo gave me a copy of an article called “And the Stuttering Just Dies” that was written by a man named Jack Menear who had overcome stuttering. A belief was born: the belief that others have overcome stuttering. Stories like this are metaphors that drove my determination.

All the time I was in speech therapy on campus I was concealing it from all but a few people. When friends saw me coming out of the building, they might inquire what class I was taking in that building, a building they were unfamiliar with. I would lie and say that I was using the restroom in that building. At one point, I had asked my clinician if she would use a plain envelope when sending me progress reports instead of stationery with a clinic address. Fortunately, they refused.

Nearing graduation in the spring of 1987, the student clinicians asked me when I thought I would be done working to improve my speech. I replied: “This May.” God is that funny now! Knowing of my plans for moving to Atlanta, they recommended I pursue speech therapy when I got there.

I wonder if the graduate students who helped me will ever read this. I hope they do. People with communication disorders worldwide can thank the professors and graduate clinicians who make speech therapy affordable to so many at university-based clinics.

Checking In

I moved to Atlanta in spring of 1987 with $150. By day I was working as a laborer for Manpower— the temporary agency. I was earning about $9 per hour carrying sheet rock. I was also accepted into a training program for insurance salesman that met in the evenings. The insurance training program required us to cold call prospects and develop a list of 500 contacts. I was hung up on chronically word substituting or silently blocking during those calls. It felt like too big a challenge, and I dropped out of the program.

But I kept pushing. I took a job at the front desk of a major convention hotel in downtown Atlanta. I had to check in customers, answer the phone, and call guests in their room. I had to speak to supervisors, go to training meetings and speak, and take on other challenges. I was definitely facing the dragon; in fact, I’d call it total immersion.

Once again I developed my personal list of feared situations. Answering the assistant manager’s private line was one of them. We were ordered to answer it within the first two rings and say: “Assistant manager’s line, this is Tim speaking. May I help you?” After a few massive blocks on the words “assistant” and “manager” I began avoiding. I would act busy and let others answer the phone, but there were some situations, for example when the assistant manager was standing right there, when I would have to answer. I would turn away so he or she would not hear me and create a block. Several times, guests who were already irate about something and calling to complain would remark by saying: “Easy for you to say,” or scoff at me in their moment of no patience.

When I interviewed for a management training position at the hotel, my supervisor asked if I could handle it with my stuttering. After blushing, I said yes. You see, I only spoken of my stuttering problem with a select few people, yet everyone knew. I moved on to manage 120 people before resigning to attend graduate school. Overall, it was another pivotal and rewarding sparring match with my dragon. I actually chose to do what I feared the most: phone use, conversations, introductions, oral presentations, and so on. I was desensitizing myself to stuttering and earning new confidence.

Later I would learn the process by which I would “grow a word fear.” It helped me understand how I acquired feared words as a child; many still provoked anxiety as an adult at this stage of my recovery. In college and early careers, words such Henry Street, manager, and others entered my daily vocabulary. When I started stuttering on those words I would remember them using a phenomenon known as somatic* memory. My brain filed them away as feared words. By attaching meaning and emotion to a stuttering event, I would remember it vividly. I would replay the moments in the cinema of my mind: hearing, feeling, and seeing the moments of stuttering. When encountering those words in the future I would feel anticipation in my stomach—a sort of panic sensation like the fight or flight response—and then avoid or speed up and stutter.

* “Somatic” means of, relating to, or affecting the body

Self-Help

At this stage of my recovery, I was devouring materials from stuttering textbooks and from the Stuttering Foundation of America. I also organized the Atlanta chapter of the National Stuttering Association and served as its president for several years. Seeing successful business people who stutter helped to minimize my fear of gainful employment in the future. Opening up, talking about stuttering, and removing avoidance was essential to my recovery.

Toastmasters

Shortly after arriving in Atlanta, I decided to confront my biggest fear—public speaking. From eighth grade through undergraduate school, I had escaped, avoided, dropped classes, switched professors, and done everything else within my power to avoid speaking in front of a group. And I had been 100% successful.

Then one day in a local paper I found an advertisement for Toastmasters. The nearest chapter was in the president’s boardroom of a local university. I knew nothing of the format for a meeting. I arrived wearing jeans and a hockey jersey. Walking in late, I entered a room with wooden paneled walls and oil paintings. Everyone else was a professional and dressed in their work attire. I later learned most of them were realtors, attorneys, and sales people.

At the end of the meeting, I was asked to stand, introduce myself, and share why I was there that evening. The hounds had me in the tree, but this time I was going to bark out the words. The room started spinning, and I thought I was going to vomit. As I stood, I kept my vow and told everyone that I stuttered and that I wanted to improve my speech. I stuttered wildly through my introduction. After the meeting, several people came up, shook my hand, and told me they would support me.

I continued in Toastmasters for five years. There were breaks as I moved around in Atlanta and joined new club’s closer to my dwellings. At the first meeting of each new club I joined, I would introduce myself and tell them I stuttered. I knew by disclosing that fact I was less prone to anxiety and avoidance behaviors. I earned two CTM degrees (Competent Toastmaster), an ATM (Able Toastmaster), and an ATM bronze. I competed in some local speech competitions and won many ribbons at the nightly meetings. I have a first-place trophy from a humorous speech contest.

When I first started Toastmasters, I was guilty of black and white thinking. After giving a speech I would judge my performance solely on how much I stuttered. If I had three or four significant stutters in a five-minute talk, I would beat myself up. It was a roller coaster the first year. Well-meaning people would give me feedback on my stuttering. They might say something like: “Tim, it’s not that bad. Just relax.” They had good intentions and wanted to help me, but because I was not open enough about the stuttering, I did not give them direction and guidance. It’s critical that the person who stutters “sets the frames (i.e.: framework)” for his stuttering. This means letting people know how to talk about it, when to talk about it, and anything else important to the person who stutters.

Communication is like dancing a waltz. Sometimes you have to ask your partner not to step on your toes. If you try to conceal your stuttering and act self-conscious about it, your dance partner may step on your toes without realizing it. Averting eye contact, substituting words, saying “um,” and other avoidances can discourage you from continuing the waltz.

I eventually got to where I transformed anticipation and fear into adrenaline. I would sit through the meeting eagerly waiting my turn to give a prepared speech. I volunteered at every meeting to do table topics or evaluate a speech. My black and white thinking started developing shades of gray. I was enjoying personal growth. Failure was replaced with feedback. If I slipped, I got right back up.

Speed skater Dan Jansen is a role model for me. In his late teens, after training since a child for the Olympics, he fell in Albertville, France. Four years later at the next Olympics, he learned his sister died moments before his race and fell again. Four more years of training, and his final Olympics, he fell during the race he was all but guaranteed of winning the gold. He had one more chance—the 1,000 meter race.

Dan was a distant third in the rankings for the 1,000. His sports psychologist told him to walk around saying “I love the 1,000.” His teammates and family were asked to listen and confirm he was saying it.

In his third Olympics and his final race, in an event where he was not favored, he won the gold medal. You may remember someone passing his baby to him to carry during a victory lap.

What was more important to him than falling? How could Dan keep getting up? How could he silence thoughts like “Others judge you…you’re a choker…you’ll never win.” His goal—the gold medal and personal redemption—must have motivated him to endure all the heartbreaks. In 1983, in Boca Raton, Florida, I saw my own freedom of speech as the gold medal I simply had to have.

Graduate School

“When the objective is clear enough, there are no obstacles” –
Napoleon Hill

I think I originally entered graduate school with the intention of learning to slay my stuttering dragon. I made an unreasonable goal of curing my stutter during graduate school. I was open about it, and all my classmates knew I stuttered.

Going into speech-language pathology (SLP) as a person who stutters has the potential to introduce a number of unique frames of thinking. Some of my “frames” were: “What will people think about a stuttering SLP?” “I must overcome it by the end of graduate school!” “How will my supervisors evaluate me in the clinic if I stutter with a client?” As a graduate student in the speech and hearing clinic we performed therapy while supervisors and parents observed through a two-way mirror. I quickly learned what it might be like to be a goldfish in a fishbowl. I was very self-conscious of the possibility of stuttering in front of the parents of the children I treated. It was the meaning and significance that I gave stuttering that was at the core of the problem.

I thought stuttering took away from my credibility. It was always a challenge for me to say “speech pathology” and “speech therapy” as I feared stuttering on those very words. That was because I was “mind reading.”

Mind reading is presuming to know the reaction of the listener. Later, I realized the humor of introducing myself as a speech pathologist specializing in stuttering while I stuttered during it. Again, it came down to whether I personalized stuttering, whether it permeated my identity, whether I thought it took away from me as a person, and whether I would have less credibility if I kept stuttering.

During graduate school in 1991, I served as a clinician at the Successful Stuttering Management Program (SSMP) in Washington State. My eyes were opened to the power of directly confronting the stuttering. Under the supervision of Dorvan Breitenfeldt, Ph.D., the clinicians and the people who stuttered went out on the campus, telling people they stuttered (advertising), and interviewed these individuals, asking them what they thought about stuttering. Phone calls, speaking into a mirror, and trips to a shopping mall to interview people were all part of the program. One of the most important things I learned was that listeners did not react to my stuttering as I presumed they did. I learned to stutter on purpose. I learned to push myself further into speaking situations. The semantic meaning that I gave stuttering was further changing. By the time I left SSMP, I had taken several more swipes at my dragon.

Lunch with Dean Williams

In 1991 in Knoxville, Tennessee I had the rare pleasure of having lunch with the late Dean Williams, a pioneer in stuttering therapy and a person who stuttered. With several other influential people sitting around, I built up my courage to ask him point blank, “What do you believe is the secret to overcoming stuttering?” He replied: “I’d want to know what I did when I stuttered.” At the time I felt almost cheated by the brief answer. However, as I drove back to Atlanta the next day, it dawned on me how profound his reply was. I still smile when I think how accurate he was. I am sure he was referring to whether I knew what I did before, during, and after the stutter. What thoughts and feelings preceded the stutter, what did I do during the stutter, and how did I reflect back on the blocks I experienced.

The hospitals

My first position as a licensed speech pathologist began in 1992. I functioned as an acute care SLP, going up into patients’ rooms. I was also on a stroke team with other therapists, nurses, dietitians, and doctors. Reflecting back, this was also a critical period on my time-line.

The meaning I gave to being an SLP who stutters manifested in situational stuttering. My percentage of fluency and how I presented myself was much improved from when I began graduate school. Toastmasters and the SSMP were a big part of it. However, I still had specific speaking situations in which I consistently felt anxiety and stuttered.

One situation that speaks volumes about my status at that time was my level of comfort and fluency when at the bedside talking to a patient and the patient’s family. When a nurse walked in the room I was more self-conscious of my stuttering and, in turn, was more likely to block. Giving formal tests where I would have to read to the patient would trigger my stuttering, especially if the nurse were working in the room. This anxiety went right back to my experience of reading in middle school. The memory of those situations, especially the way I felt at the time (my somatic memory), still had enormous power to run my life.

Speaking to doctors brought out some of my worst stuttering. When they entered room, it was as though I were two people. If I had stuttered in front of that doctor before, I would remember that and get anxious. If I did not know the doctor, I would become anxious because I wanted to conceal the stuttering. Typically, I would have my worst stuttering when calling a doctor’s office for orders to see a patient.

This, of course, was a combination of my timeline of phone avoidance combined with the meaning that I gave stuttering as a speech pathologist. (A “stuttering timeline” is similar to the type of timeline you see in a textbook that records historical events along a horizontal line.) I believed that if a physician heard me stutter, he or she would think less of me and would give me less credibility. Typically, my stuttering would be triggered by the memory of a specific phone call 20 years previously in which I stuttered. The embarrassment and shame I had attached to these early calls explained my ability to recall them so vividly.

It was those early remembered feelings—the somatic memories—that explained why I had so much anxiety in my stomach and chest before calling. It was as if I were experiencing those early crises all over again. I believed that leaving a voice mail was worse than talking to a live person. If I stuttered, they would have permanent history of it. So I would mind read and presume that what I thought they thought was the actual truth. I later learned that these were only my projections.

One time when calling a doctor’s office and introducing myself to the receptionist I had a massive block on my name and the title “speech therapist.” In response to my stuttering, the nurse started laughing. I said, “May I presume you laughed because I stuttered while announcing myself as a speech therapist? I happen to be a speech therapist who stutters.” When she began to apologize, I assured her that I might laugh, too, in the same situation. Perhaps she had thought it was a prank call at first. Considering she was a member of the general public with little or no knowledge about stuttering, I can now see the potential humor of the situation.

We started talking, and she told me her grandchild was starting to stutter. Using the internal mail in the hospital, I sent her materials from the Stuttering Foundation of America. We maintained a dialogue for a couple months as I continued to advise her and her daughter.

Her granddaughter benefited from my willingness to take a second perceptual position. What I mean by “second perceptual position” is that I considered what her experience might have been when I first called and stuttered. By considering the position of the listener, finding humor in it, and immediately forgiving her for laughing, I was able to turn the interchange into a win-win situation. Had I responded the way I traditionally did and ended the call with my tail between my legs, it would have been a loss, not just for the both of us, but for her grandchild as well.

One day I was talking to a neurologist with whom I had frequent interactions. As we sat at a nursing station he asked me why I had gotten into the field of speech pathology. He said I was the first male he had ever met who was an SLP. I told him that I stuttered and that I had gotten into the field to help myself and help others. He said, “You know, it seems to me I have heard you stutter a few times. And come to think of it, you are ideal for your job. When you go to see my patients who have had a stroke and cannot speak, you bring a compassion that others might not have.” I remember that as being a very emotional moment. In fact, tears just welled in my eyes as I dictated that quote into my IBM voice recognition software.

That moment was like the proverbial hand slap to the forehead. In an instant, he reframed several years’ worth of illogical thinking about being an SLP who stutters. Once in awhile people will say something seemingly simple that will suddenly change your mind. It was something I knew but was refusing to believe because of my habit of mind reading. That moment has continued to have a profound impact on my life.

Another profoundly important moment on my recovery time line was when I was going through orientation at a hospital and was told I would have to page people on the intercom. That meant several hundred people would hear me speak at once. As toxic thoughts entered my mind, the dragon belched his nasty breath. I took a quick inventory of the mental “frames” that controlled my thinking at that moment. They could be summarized as this: “If I stutter, people will ask who was that? Oh, it is the new speech pathologist stuttering. Who hired him? They’ll hire anyone!”

I knew I had to find a reason to page someone that very day. If not, I would develop a phobia. Even though I had no reference for an intercom in my life, I projected the fear based on past references of stuttering on telephones and at drive-through windows. I got ready to page respiratory therapy to a room I was working. My Linguistic Search Engine predicted I would stutter on “respiratory.” I felt panic. I decided to face the dragon head-on. I walked to the nursing station with a speaker directly above me, and several people sure to connect my voice and face to the intercom.

I looked right at a nurse and elongated the /r/ sound; getting the page out free of a stutter. It took great restraint to not do an end zone dance and spike the phone. A huge moment! My mental radar had picked up the toxic frames of thought, I faced the dragon, and slew it.

Over my first eight years as an SLP, I gradually improved my fluency and freedom of speech. In serving several hundred patients, only two times did a parent of the prospective client mention my residual stuttering on the phone during an initial contact as a reason why they would seek services elsewhere. I have lost track of the number of times parents of children who stutter and/or adults who stutter have cited my history as a reason why they chose to work with me. It was important to keep track of that ratio in my mind.

The phone was my last link in the chain. Sometimes I would go months at a time with relative easy introducing myself on the phone. Other times, the somatic memories of earlier catastrophes would fire up my anxiety, and I would really have to focus on my stuttering modification tools: easy onsets, light contexts, and pull-outs. They worked most of the time, but not always. During the recovery process, there are always times when the person’s anxiety is so overwhelming that his or her speech tools don’t work. This is why it’s necessary to develop strategies for running your mind as well as your speech.

Neuro-Linguistic Programming

I first tumbled on an NLP book in 1995. As I read it, I found descriptions of therapeutic processes that looked applicable to stuttering therapy. They talked about concepts such as re-imprinting painful memories, visualizing to prepare for future events, conversational reframing, learning how to relax in a matter of seconds, how to get into rapport with people, and how to manage your physical and mental state. I knew my stuttering was much more than simply a motor speech problem. There were too many inconsistencies in that theory. How could I be spontaneously fluent in so many contexts using no modification strategies at all? How did I “turn on my stuttering” consistently with certain people or in certain situations? How is it that specific words from childhood would still provoke a panic attack? NLP seemed to offer some of the answers.

NLP is an umbrella term that encompasses a myriad of therapeutic processes originating from the cognitive-behavioral sciences. The pioneers of speech pathology have utilized gestalt therapy, Rational Emotive Behavioral Therapy (REBT), transactional analysis, Carl Rogers’ Rogerian-style counseling, reframing, and many other approaches. Drawing ideas from psychotherapy is not new to speech pathology, and desensitization to stuttering is absolutely critical to complete recovery.

After confirming the relevance of NLP processes to traditional speech pathology, I decided to earn my NLP practitioner certification. This was a 150 hour experiential, classroom process. The final weekend included an outdoor ropes course. Each activity on the ropes course was set up as a metaphor for change. We would identify an obstacle in our life—a thought or feeling. There was then a physical manifestation of that obstacle in the form of a challenge that we had to overcome. I started to change inside out. I began learning strategies to run my brain. All of this was applicable, not just to my own recovery process, but to my practice as well.

2001 to Now

“It is by changing our inner thoughts that we change our outer behaviors.”
– William James

By 2001, I had been using stuttering modification, desensitization, voluntary stuttering, and pushing myself into more speaking as my framework for recovery for 15 years. My stuttering had become so situational and context specific that I felt like it was just a matter of time before it was defeated. If I stayed focused on those last few targets, and figure them out, I would finally have spontaneity. I knew that closing the final loops would be difficult. Nevertheless, I knew there was no quitting now. As former Green Bay Packer football coach Vince Lombardi once said: “The harder you work, the harder it is to surrender.”

I started corresponding professionally with Bob Bodenhamer, a trainer in NLP and Neuro-Semantics®. Finally, I had found an authority on NLP who had a specific interest in helping people who stutter. He helped me identify specific therapeutic processes in NLP to eliminate the thought patterns that led to stuttering. He put me through these processes and then taught me how to do them.

As I continued to resolve my remaining stuttering I noticed that my stuttering seemed to follow a 1-2-3 sequence:

1. Negative thoughts. The circumstances leading up to a block usually began with a negative thought. After 15 years of hard work, my stuttering had become very context specific. I could pretty much name the people, places, and words I still stuttered on. The blocks were usually preceded by negative thoughts such as “I anticipate stuttering.” “I do not want to stutter with this person.” “This word is hard for me.”

2. Anticipatory Anxiety. This is also known as the General Arousal Syndrome or the fight-or-flight-response. My negative thoughts would instantly lead to anticipatory anxiety. When I anticipated stuttering, I always had a nervous sensation in my stomach that felt very much like panic. The level of panic was usually dependent on the situation.

3. Choice Point. Someone once said that “between a stimulus and a response is a choice.” In the past, once a thought about stuttering (#1) had created anticipatory anxiety (#2), I would do one of two things:

a) Avoid: use tricks like saying “um,” switch words, not raise my hand, and employ other strategies to try to not stutter. In this situation my intention was to protect myself from the pain of stuttering and more important, to shield myself from all the bad things that stuttering meant to me.

b) Push and block: this is the impulsivity that I had translated from mind into muscle. In a state of panic, to rid myself of my anxious feelings about stuttering, I would jump into a word and create some or all of my familiar stuttering symptoms (repetitions, blocks, facial contortions, eye contact aversion, etc.)

It is essential that a person who stutters slow down his mind and body so he or she can make different choices and practice new behaviors. This is called “interrupting the pattern” or “breaking state.” Thus, once I was in a moment of anxiety about stuttering, or actually stuttering, I had to find ways to interrupt this process.

Through traditional speech therapy I had learned to get myself out of a block by executing a “slide.” A slide is done by prolonging the first sound of the word with light contacts in the articulators and larynx. If I started to stutter, I would use a “pull-out.” A pull-out involves realizing the block, stopping your speech completely, and then saying the word again with a slide. But when my anxiety was raging, my mind went numb, and these strategies would become difficult and sometimes impossible to use. The classic strategies did help me reduce the severity of my stuttering over a 15 year period, but I found that even when using slides and pull-outs, there was still a level of tension in my larynx, mouth, and abdomen. The amount of anxiousness about stuttering dictated this level of residual tension. And ironically, the more I would try to prevent stuttering, the more tension I created.

Previously, I had never paid much attention to the sensations in my abdomen. I didn’t think they were significant. I always focused on managing my stuttering in the area between my larynx and mouth using slides and pull-outs. But now, I was also doing my best to desensitize myself as well. I was seeing the importance of digging deeper and understanding my anticipatory anxiety.

Since the feeling of anxiety in my abdomen was a messenger telling me to use the slides and pull-outs, I wondered what would happen if I could remove that very anxiety. It made sense that the thoughts and feelings I had about stuttering that caused the anxiety was the core of my problem. Could I learn to say the words without any anxiety, residual tension, and without having to resort to slides and pull-outs? That’s when I started changing my objective, moving away from focusing on motor speech strategies to removing the process that created anxiety.

My new choice was to use a neuro-semantic technique to resolve the anticipatory anxiety. It is called “Drop-Down Through,” and it helped me reframe my thoughts to eliminate the panic sensation in my stomach before initiating speech. Now, instead of focusing on a fluency technique such as the easy onset, I focused all my energy and attention on the release of the anxiety. When the Drop Down Through technique was done effectively, the word was uttered with no residual tension in the articulators.

In the summer of 2002, I earned my master practitioner certification in NLP. This was a 14-day intensive course with Bob and L. Michael Hall.

What I learned

Considering my family history of stuttering, perhaps I was predisposed to be at risk. However, I have learned what I believe to be the key contributing factors to my stuttering, and the necessary components needed to recovery. Here are some of the concepts, tools, and techniques that I’ve found useful.

• Somatic memory. As mentioned earlier, this refers to the physical sensations associated with a past event—a kind of mental movie in which we can re-experience what a previous event actually felt like. Try it out. See if you can vividly recall a wonderful vacation or holiday. Notice the positive sensations. If it was a holiday at the beach, notice the warmth of the sun on your skin. Smell the salt air. Feel the sand under your feet. Thinking back on such pleasant moments will help you recall the good feelings associated with this earlier experience.

However, the reverse is also true. Recalling negative memories will trigger uncomfortable feelings. I started a list of specific situations, people, and words in which I anticipated stuttering. I clearly defined what these moments meant to me and identified the specific feeling patterns. For example, when I went to use the intercom at that hospital, even though I had never used one before, it brought back my phone phobia, which in turn, led me to feel like I would stutter. It also recalled my tendency to mind read what my listeners might think if I did stutter. My list of other feared situations included the telephone, reading aloud, oral presentations, specific girls names, my street name, my own name, and saying the word “stuttering.”

I began to see that if I sat in class “knowing” I was going to have to read aloud, my somatic memory would trigger the panic sensations associated with similar unpleasant experiences from the past. This is what inevitably led to my stuttering and blocking. My big question became—“What could I do about it?”

The good news is that negative memories can be edited and the emotion removed from them. There are a number of strategies that allow me to observe a past stuttering event, change and “reframe” the meaning I had assigned to it (i.e., embarrassment over teasing), and then alter the visual picture of the event. Once the meaning has changed and it is difficult to visualize the event anymore, the unconscious mind will not reflect back on these time-line moments. The only way I knew to anticipate stuttering on certain words, in specific situations, or people was to reflect backward with somatic memory.

Once my somatic memories of stuttering were edited and stopped showing in my “mental cinema” I experienced less of the panic sensations in the specific situations I would consistently stutter. That allowed me to initiate speaking with ease and confidence.

• Anchors. An anchor is a specific memory that allows you to tap into the feelings and meanings of a previous experience. For example, think of a favorite song. You can go back and fully experience where, when, and with whom you heard it, how you felt, and so on. You can choose to replay the song to re-experience what you felt like back then. The song becomes an anchor to that earlier, positive mindset. Going back to re-experience a past feel-good event explains why we like to repeatedly play particular songs, albums and movies.

Through many uncomfortable speaking experiences, I began to see how I had developed a stuttering timeline with anchors to many fearful words and situations. Whenever I experienced one of these stuttering anchors, I would slip into my familiar panic state. For example, when the assistant manager’s line rang at the hotel, I was instantly anchored to an earlier feared event, and I’d quickly slip into a state of panic.

On the other hand, if at the first sign of fear I could anchor myself to a positive experience from the past, I could short circuit that panic state and stop it from developing.

• Time line. Each situation in which I’d stuttered and endowed with embarrassment, shame, and frustration became another point on my stuttering time line. Eventually, this time line stretched over 20 years. Points on this time line were somatic memories and anchors for specific moments of stuttering, and they heavily influenced my present behaviors and choices.

For instance, how would I know to anticipate and avoid specific words or situations if not for previous references? Sometimes I would find myself drifting back and replaying past moments of stuttering or imagine that my stuttering was to blame for events that did not turn out as planned.

One thing that neuro-linguistic programming offered was an approach to time line re-imprinting. By going back and changing the meaning I gave to the stuttering that came up with I read aloud, and doing this all along the timeline, I eliminated the anticipatory anxiety that always preceded reading aloud. Today, it is very rewarding to read verbatim during an oral presentation or sit on the sofa with my children and read them stories without ever thinking about stuttering.

• Linguistic Search Engine (LSE). This refers to the mechanism in our brain that allows us to instantly identify a feared word. The LSE is like a forward-looking radar on a jet fighter that’s flying low to the ground. It scans ahead for potential dangers so it can take evasive action. With stuttering, it allows us to reach ahead and instantly identify the feared word. For instance, when I moved to Atlanta from Wisconsin, if I was suddenly asked where I was from, my LSE will alert me to a feared word (Wisconsin). I would panic and say “up north” or go into a block. Many people have told me how they look ahead of the passage they have to read and identify specific words they fear stuttering on.

By re-imprinting our somatic memories of feared speaking situations and removing negative meaning from them, we find it less and less necessary to fire up our linguistic search engine. The only reason we remember the stuttered words in the first place was because we applied meaning to that past moment of stuttering. Thus, when the search engine is not running any more, we remain more grounded and fully in the present.

• Reframing. If stuttering events were emotionally neutral to us, would we recall stuttering and make choices to change words, look away, avoid, and the like? I think not. Anticipating stuttering, feeling panic, remembering specific words, sounds, speaking situations, and all other cognitive memories of past stuttering events are made possible only when we apply meaning (negative) to stuttering.

Alfred Korzybski, the developer of general semantics, said: “Human beings are a semantic class of life.” What he means is that humans are programmed to endow their experiences with meaning. We do that by setting up frames-of-reference. Hence, it is essential to reframe the very meaning we have created for our stuttering. Remember how I thought that my stuttering meant having no credibility around doctors. That frame was what triggered the panic sensation and led to stuttering. Marcus Aurelius once said: “Men are not disturbed by things, but by their estimate of things.” He meant the meaning we give things.

One part of the recovery process, then, is to reframe the meanings we give to the speech-related moments of our life — turning negatives to positives.

• Breaking state. I had to learn to identify when I was going into a stuttering state and break, or interrupt, that state. When I realized that I felt anticipation in my stomach prior to stuttering, it made sense to me to look into that and see what I could change. By using time-line therapy techniques, reframing, the Drop-Down Through process, and other neuro-semantic and NLP processes, I was able to gradually dissolve the panic feeling that preceded stuttering. My speech flowed more and more spontaneously without ever having to resort to my old fluency modification techniques. I just talked without interruption.

Peeling back the layers of the onion

In summary, it was essential that I re-imprint my time line—that is, reframe and revise the negative speech-related experiences covering many years—so that the memory of past stuttering disasters did not continue to cause anticipatory anxiety in my present life. Re-imprinting memories of stuttering erased many of the frames-of-reference they created for situations such as oral reading, telephone, and oral presentations.

Could Dean Williams have been planting this very seed in my brain in 1991 when he asked me if I wanted to know what I did when I stuttered? I like to think so. The evidence of my recovery is that I no longer think about stuttering nor do I rely on behavioral fluency strategies to produce modified fluency. I no longer even feel the sensation of anxiety in my stomach. I just talk.

At the time this article was written, March 2003, I have anticipated a stutter five times in the last six months. They were old references, old feared words that popped up in my linguistic search engine. One of them arose when I asked to speak the manager at a hotel. As I did with the other four occurrences, I used a neuro-semantic process like reframing or the Drop Down Through process to remove the anxiety, and I was able to speak fluently.

Today, before a public speaking engagement, my focus is on pushing myself to achieve excellent platform skills. I still have the normal, typical disfluencies that all speakers have (i.e., loose whole-word repetitions), but my blocking and struggle behavior are history.

This is further evidence of the power of clearing my head of stuttering thoughts. I am 100% confident that I am now cognitively Teflon-coated and relapse proof.

Having come this far, do I regret that I had to endure more than two decades of stuttering and self-punishment? No. Next to Christopher Reeve’s ability to stay positive with quadriplegia my story seems trivial, although I know it’s not. I believe I am a more compassionate person, a better parent and spouse, and I love my work as a speech pathologist. The journey through stuttering has been a personal metaphor that will make all things possible for me.
The dragon’s fire is out.

Author

Tim may be reached through his website at http://www.stuttering-specialist.com

Filed Under: Articles by Tim Mackesey

Developing a Propulsion System for Fluency

January 30, 2011 by Bobby G. Bodenhamer

by Tim Mackesey, CCC-SLP

Pour la traduction française, cliquez ici (PDF)

Purpose

The intention of the State Management Graph below is to help people using Neuro-Semantics to habituate the use of strategies.  Daily use of strategies will provide for more consistent resourcefulness and improved fluency.  To make sense out of the acronyms and terminology in the graph, a background in Neuro-Semantics is required.  Many of these strategies are available for free as downloads from www.neurosemantics.com.  Others are outlined in Bob Bodenhamer’s training manual, Mastering Blocking & Stuttering: A Handbook for Gaining Fluency, available on-line through the website.

What is a state and why is important to me to manage mine?  A simplified definition of a state is how resourceful you are feeling and thinking at a given moment.  In the body of a person who stutters (pws), a state can be measured by rate of breathing, degree of muscular tension (particularly in the torso, larynx, tongue, and lips), energy level, blocking, rate of speech, and many other dynamics.  In the mind of a pws, a state can be evaluated by terms such as mood, feeling safe or threatened, anticipatory anxiety, confidence, beliefs about listener’s reaction, and other cognitive-linguistic phenomenon.  If you manage your state, you run your brain; and vice versa.

PWS, like all other human beings, are at-risk for embarking on personal change and then becoming complacent or “forgetting” to do the very strategies they know help them.  Do you know anyone who announced a “New Year’s Resolution” and did not achieve it?

Someone once coined the expression that is takes 21 days to form a new habit.  By using the graph and holding yourself accountable you will form new habits.  To succeed a person must have a compelling future image of what it will be like to have freedom of speech, specific strategies, beliefs to support success, a strong purpose for achieving it, and then make a decision to DO IT.

Towards Motivation

Towards Motivation occurs when we are driven to achieve a compelling outcome.   An outcome must have significant meaning to us.  When this propulsion system is programmed into your mind, it works like a guided missile.  Every pws I coach comes to me with “away from motivation.”  They are trying to not stutter.  They have, in effect, developed a propulsion system programmed to prevent and avoid stuttering.  This missile will miss the target.   Below is an example of away from patterns common to pws:

( – )                                                                                                      ( +)

AWAY FROM STUTTERING                                                                     TOWARD FLUENCY

<——————————————————————————————————————–>

–        word changing

–        avoiding talking

–         eye contact aversion

–         telephone avoidance tricks

–         blocking

–         mind-reading listeners

–         interjections and filler words

–         other attempts to conceal stuttering

–

Obviously, the pws must abandon each of these toxic, away-from patterns listed above if they desire to change.

Taking the concept of towards motivation and making it your propulsion system is critical to state management and eventual consistency in speech. Cognitive psychologist L. Michael Hall, coined the term mind-to-muscle (Hall, 2000) to describe how we take a principle and make it a daily habit.  The graph is designed to help mind-to-muscle the use of the strategies.  A pws can analyze his state, select a strategy, create a more resourceful state, and keep a score card by the graph.

How is that an obese person can dramatically change his entire being by sticking to an exercise regimen, changing his entire diet, and becoming disciplined?  They must have propulsion system.  A person who loses weight, and keeps the weight off, is motivated by either pain or pleasure.  Pain can originate from a doctor scaring them with suggestions of future health trouble.  Pleasure can come from making an image of themselves at their ideal weight.  Whether the motivation for weight loss originated as a toward or an away-from pattern the successful dieter had to mind-to-muscle significant exercise and eating habits.  These changes become a new “operating system.”

People who stutter know how to stutter very well.  What I mean by this is that they have repeated patterns of thinking, feeling, and stuttering for years.  When they begin to relapse the vortex opens and sucks them in.  I stuttered severely well into my 20’s.  If I was making gains for several weeks or months, it would take one incident of embarrassment about my stuttering to set it all off.  It was like a computer program that was saved on my hard-drive (my brain) would open and run automatically.  No matter how terrible I would feel about my stuttering, or how severely I would start blocking, it seemed so familiar and I felt helpless to it.  I would start avoiding and fearing the relapse.  I would slip right into the away-from patterns listed above.  I eventually learned strategies from the domain of cognitive psychology to handle this roller coaster.

Eventually, a pws can learn to use strategies to prevent going into the stuttering state.  Breaking out of the stuttering immediately is critical

To preventing relapse and regaining a resourceful state.  Most of the strategies can be used before, during, or after talking depending on the intention.  For example, the Drop-Down Through, Fifth Position, Foreground/Backgound, and others can be used in four different scenarios: 1) as a future pacing process early in the morning to manifest a resourceful speaking day, 2) when anticipating stuttering to remove anxiety, 3) during a speaking moment to relax and manifest fluency, 4) to re-imprint a moment of stuttering that the pws disliked.  I personally believe that re-imprinting past stutters is critical to remove time-line references that will in-turn reduce or eliminate anticipatory anxiety.  The table below offers a pws a practical resource to help habituate the use of strategies.

Get Started

Print off a minimum of 60-90 copies of the graph.  Plan on devoting 2-3 months in order to mind-to-muscle these strategies.  Take a 3-hole punch and put the graphs in a 3-ring notebook.  Review the neurosemantic strategies and get started.  Become active in the on-line discussion group for support and “pointers.”   Like all other self-improvement endeavors, some people may benefit from a personal coach.  Assess your “state” first thing in the morning.  If unresourceful and/or anticipating stuttering, pick a strategy and do it.  Mark the acronym on the graph and reassess your state (-10 to +10).  I highly recommend an early morning future pace strategy such as the meta-alignment.  As you move through the day take inventory of your state and use strategies as necessary.  Remember that it is essential to break state immediately after discovering a pre-stutter state or noting any negative thoughts or feelings after a stutter.  How do you know if a stuttering event warrants re-imprinting?  If when you begin to “run a movie” about it and actually feel discomfort, re-imprint right away.

Caveat:  You may become so good at running your brain that you manifest numerous wonderful things in your life.  If abundance, fluency, and feeling great scares you, discard this road map.

References

Hall, L. Michael.  (2000). Secrets of Personal Mastery. United Kingdom: Crown House Publishing


DAILY STATE MANAGEMENT

STRATEGIES

The following table contains a list of strategies and their acronyms.


ACRONYM
TERM
5P =  5th Position

DDT = Drop Down Through

EFT =  Emotional Freedom Therapy

FG = Foreground/Background

FP = Future Pace

ACRONYM

TERM

MA =  Meta-Alignment

MQ = Miracle Question

MYN = Meta Yes/ Meta No

PT = Phobia Theater

RF = Reframing Self

ACRONYM

TERM

KDD = Kinesthetic Drop Down

TLR = Timeline Re-Imprint

SWP = Swish Pattern

GI = Guided Imagery

AWARENESS STATE

Enter the appropriate strategy acronym in the box that corresponds to your awareness state at a particular time.

+10
+9
+8
+7
+6
+5
+4
+3
+2
+1
0
-1
-2
-3
-4
-5
-6
-7
-8
-9
-10
5AM 6AM 7AM 8AM 9AM 10AM 11AM NOON 1PM 2PM 3PM 4PM 5PM 6PM 7PM 8PM 9PM 10PM 11PM MID-
NIGHT

Filed Under: Articles by Tim Mackesey

Stuttering and Volcanoes

January 30, 2011 by Bobby G. Bodenhamer

Most of the “meaning” lies beneath the surface

PDF File

Filed Under: Articles by Tim Mackesey

Put a Spell on Stuttering

January 30, 2011 by Bobby G. Bodenhamer

Read about Tim’s utilizing metaphors from Harry Potter in working with a 13 year old PWS.

PDF File

Filed Under: Articles by Tim Mackesey

Stuttering: When Attempted Solutions Become the Problem

January 30, 2011 by Bobby G. Bodenhamer

By Tim Mackesey PC, CCC-SLP

How is it that people who stutter develop body movements, look away during stutters, change words, avoid talking, and other maladaptive behaviors?  What motivates them to make these choices? These begin as attempted solutions but become habitual and develop into real problems and secondary symptoms.   How can we help them eliminate these behaviors?

Hank, a 4 ½ year-old boy, entered my lobby making a loud “huh” sound as he exhaled with great force and drama.  He was also saying “mmm” very loudly and making his pitch increase.  His eyes would look up to his right side and strain during these speech blocks.  After closer examination it was evident that Hank made the “huh” sound just before any word beginning with a vowel and the “mmm” sound just before any word starting with a consonant.  Anticipating a speech block as his larynx tightened, Hank used the “huh” or “mmm” as an attempted solution to prevent or escape the stutter.

Many preschoolers have developed what are called escape behaviors. In trying to escape the moment of stuttering and the physical tightening the child may blink his eyes, tap his foot, nod his head down, or similar signs of tension and struggle.

Preschoolers are quite capable of remembering problem words and avoiding them.  One 4 year-old I evaluated had abandoned the word “I” six months before I met him.  He was using his first name or “he” when referring to self.  His parents described months of chronic and severe blocking on “I” preceding his choice to eliminate the pronoun from his vocabulary.  When “he” became hard, the boy interjected “says” several times before “he.”  When you think about it, this avoidance requires a great deal of concentration and pre-planning of words.  His attempted solution became the problem.

Numerous speech games that involved saying “I” got rid of the problem and unleashed consistent fluency.

Adolescents, teens, and adults who stutter often have a long list of tricks designed to prevent stuttering.  One adult with the fear of asking for people and saying his own name on the phone had gathered his friend’s cell phone numbers.  That way he could connect directly with people and avoid what he feared.  This attempted solution only made the fear of asking for people and saying his own name grow in intensity.  A software engineer in a large four story office would email or walk to his co-workers offices.  He would never call them when they were at their desks.  If he had to call, he would leave voice mails during lunch or after hours.  He had learned which code to key in to re-record the messages until he was satisfied.  He rationalized his avoidance tricks by thinking his peers would perceive him as devoted or a workaholic when they noticed lunch and evening messages.

“Freedom is to speak.  And, I fear to form what is air (speech)
and may be made in a minute (a stutter.).  –
Michael McClure

Fight or Flight

What is it about the experience of stuttering that people who stutter are so motivated to prevent and conceal stuttering?  Preschoolers feel the physical struggle of a stutter, their vocal cords adduct and tighten, and fight against it by pushing (blocking) or avoid and give up.  Being in Piaget’s Preoperational Stage of cognitive development (age 2-7), they do not remember stutters as traumatic and do not personalize stuttering like the child age seven and older.  How then must it feel inside to stutter that a preschooler may start changing words, use character voices, insert “uh um” just before a speech block, or verbalize frustration to their parents?

According to Guitar (1998), the Borderline Stutterer has mostly loose and relaxed disfluencies and rarely reacts to them.  The Beginning Stutterer has more tension and hurry in the stuttering.  Further, the Beginning Stutterer is aware of his difficulty and frustrated but does not yet have strong feelings about self as speaker (identity).  The Intermediate Stutterer – typically between the ages of 6 and 13- is starting to fear and avoid stuttering.   His classifications of stuttering development and severity take into effect physical/behavioral symptoms (i.e., tension in the moments of stuttering) as well as the cognitive and affective issues related to stuttering.

Once a child develops the identity of a stutterer she will often go into a defensive mode and try to conceal it.  Embarrassment and listeners reaction usually motivate this covert operation of hiding stuttering.  People who stutter demonstrate a higher level of cognitive anxiety than normally fluent speakers (DiLollo, et al 2003).

The Fight or Flight response is our body’s primitive, automatic, inborn response that prepares the body to “fight” or “flee” from perceived attack, threat, or harm to our survival.  Originally discovered by Harvard University physiologist Walter Cannon, this response is hard-wired into our brains and represents a genetic wisdom designed to protect us from bodily harm.  This response actually corresponds to an area of our brain called the hypothalamus, which- when stimulated- initiates a sequence of nerve cell firing and chemical release that prepares our body for running or fighting.  When we experience the Fight or Flight we feel a sensation of panic in our soma (body) as adrenaline, noradrenaline, and cortisol are released into our bloodstream.  The panicky sensations just before a stutter are similar to the Fight or Flight response.  When one understands and appreciates the intensity of this panic sensation in people who stutter he can then grasp how elaborate avoidance strategies are common.

When our actual physical survival is threatened, there is no better response than to have the Fight or Flight.  Unfortunately, we can assign a meaning of threat to a behavior called stuttering and experience the Fight or Flight response when stuttering or blocking is anticipated.  The young child can strongly dislike the experience of being unable to speak.  The adolescent, teen, and adults can remember painful moments of stuttering on time-line and perceive threat (i.e., embarrassment, shame, teasing, bombing a job interview, rejection from an attractive person, and so on) and fire off the Fight or Flight.  This phenomenon of remembering stuttered events and fearing future ones has led to stuttering being called a variant of Post Traumatic Stress Disorder (Starkweather, 2003).

“Stuttering is everything we do trying to not stutter.” Wendell Johnson

Attempted Solutions

A text book would be required to list all the attempted solutions tried by people who stutter.  Here is a list of some of the most popular forms of Fight or Flight:

  • Movement of the extremities: arms, hand tapping, finger fidgeting, and foot tapping (or stomping).  Unfortunately, some of these are taught by well-meaning parents and professionals.  During the moment of blocking and tension the movements are not subtle and rhythmic as intended.  For example, a first grader who chronically blocked on words starting with /s/ was taught to put his hands in front of him and pretend he was pulling on a rubber band before starting the word.  As he experienced a speech block, his eyes rolled back in his head and his arms jerked bringing more attention to his stuttering and not helping him ease into the word.  The attempted solution created a glaring secondary symptom.  I showed him pictures of items beginning with /s/, had him rest his hands on his lap, notice the feeling of anticipation in his chest and throat, exhale slightly, and say the word.  Then I asked him do you need or want your hands to say /s/ words?  He said NO and we solved this problem.
  • Head movements:  I separated this from extremities because of all the directions the neck and head can go.  I have seen people who stutter nod their head as they force out a word, roll their head up and back, or jerk it to the side.  This attempted solution- which brings great attention from listeners- is to force the word out.
  • Eye contact aversion: this is the purposeful breaking of eye contact just before and during stutters.  I have seen it in self-conscious preschoolers and see it in nearly all teens and adults when I first meet them.  After interviewing several hundred people who stutter and avert eye contact, the positive intention (attempted solution) is to not see the listener reaction during the stutter.  These people remember listener reactions that they found unpleasant – sometimes teasing- and want to prevent seeing anything that resembles those moments.    However, when the person who stutters is feeling self-conscious and nervous, the stutter intensifies in a physical sense and the cognitive and affective issues are reinforced (Mackesey, 2002).  Listeners still see the stuttering and actually become uncomfortable since the person stuttering is looking away from them.  I have interviewed several people who don’t stutter and they reported starting to look away because they felt the person stuttering and averting eye contact wanted them to!
  • Escape behaviors: as mentioned earlier, these can include something subtle as eye blinks, but also include movement of extremities.  The person stuttering is trying to escape the shackles of the speech blockage.
  • Deep breaths: before I explain this one I want you to try an exercise.  Put your hand on your chest and count out loud to three without taking a breath first.  That’s right, just let your chest gently fall as the air and words come out.  Once you’ve mastered that, count to five.  Then I want you to rest and go to ten.  This is very easy- not rocket science.  After going to ten, you have proven the ability to say ten words without taking a breath!

Many people who stutter take a deep breath immediately before they manifest the speech block.  Some were taught to do it.  Unfortunately, when anxious the breath is high in the chest and not from the diaphragm. So, they feel a stutter coming and take a quick and deep inhalation with the positive intention of thrusting the word out without a stutter.  But again, the attempted solution becomes the problem. The extra air and force in a moment of panic about a   stutter is like pouring gasoline on a fire.

I help people “block the blocks.” This means they learn to feel the stutter, stop, relax, and begin the word as they gently exhale.  Remember, they have all the air they need for a word, phrase, or short sentence residing in their chest- it’s called residual capacity (Nicolosi, 1989).

It is understandable that the lay person observing blocking and apparent running out of air might say “take a deep breath.”  Scientists have discovered that the diaphragm and chest tighten during the Fight or Flight.

Not only is it unnecessary to take a deep breath, it is not suggested when the anatomy of the torso and larynx constricted and feeling like a panic attack.

  • Interjections and starters: In normally fluent speech there are “thinking um’s.”  In stuttered speech, you will hear sounds, words, and phrases inserted with the purpose of preventing stutters.  Specifically, when the person feels a stutter coming they insert unnecessary junk attempting to delay or avoid blocking.  This can habituate and become a very obvious and distracting symptom of stuttering.  One adult I met trained himself to say “well basically” or “honestly” up to eight times preceding a stuttered word.  Another closed his eyes and said “um” 58 times before attempting his name.  Since this reinforces fight and flight it is really stuttering; it is blocking to not block.  For a person to learn to manage the moment of stuttering he must remove interjections and starters.  When motivation, behaviors, and choices are designed around attempting to conceal stuttering, the results will always be a problem.
  • Word Changing: Another attempted solution becoming a problem is word substitution.  People who stutter can store in memory a number of words that they fear stuttering on. When I moved from Wisconsin to Atlanta with a real stuttering problem I would answer “up north” to inquiries of my home state. This only exacerbated the fear of stuttering.  If you want to be on the swim team, you have to get in the pool, right?  If you want to eliminate the fear factor on any given sound or word, you have to take it on and say it.  Many have reported ordering a food item based on what they feel they can say without stuttering instead of their desired food item. This is sad indeed.  Some have shortened wedding vows to eliminate “feared words.

I once met a man who bought a company that was named after a word he had never said before in his life. He began stuttering on the name of his new company.  Then he started circumlocuting, which means talking around the word (i.e., “um it is like in the media industry.”)  After several experiences of blocking when cold calling to sell his service he started requesting his secretary to call and ask for people and then patch him through on the phone at his desk.  Asking others to speak for us is enabling the problem.  Do you see how he developed a full-blown phobia in a matter of two months?

  • Avoiding all together: this category includes all the people who stutter who don’t raise their hand in class, don’t approach and introduce themselves, hang up when voice mail comes on, decline a role in a play, settle for jobs with less speaking, don’t call for a date, decline invitations to social activities where speaking to a stranger will happen, and a myriad of other avoidance strategies. The attempted solution in avoiding is to conceal, prevent, and/or not experience stuttering.  The term social anxiety is often used in describing the phobia-like experience in stuttering.
  • Phone tricks: along with public speaking, telephoning is one of the most common phobias of people who stutter.  Even with the invention of the internet, the phone and verbal communication is not going away.  I feel that the phone is a life skill!  Being able to call “911,” call for doctor appointments, call to set up job interviews, and the like are critical.
    I recently met a 40 year-old professional who reported re-recording voice mails up to 20 times in pursuit of a fluent message.  When asked his criteria for a success, he responded: “One with just a small stutter.”  He laughed when I asked if he times the stutters with a stop watch or uses biofeedback to measure acoustics and sound.  The real issue was his toxic belief: “If someone hears me stutter, they will think I am not competent.” He admitted imagining that people would play the message and scoff…or even share it with others.  These self-made mental movies full of mind-reading (Burns) drove his phobia.
  • Enabling: this problem disguised as a solution summarizes all the ways that well-meaning family members, teachers, and friends make the problem worse.  When a parent and teacher make special arrangements that excuse a child from speaking in class, do you think that reduces future fear?  No, this type of enabling ensures future fear in similar situations and also plants a limiting belief that sounds like this “Because of my stuttering, I can’t talk like the other kids….I need preferential treatment.”I once helped a college freshman who had dropped four out of five of his first semester classes. Why you ask? After finding out that oral participation was required he panicked and dropped 80% of his classes. Looking back to his high school experience, he had been allowed to deliver oral presentations on video for only the teacher to see and was excused from oral reading.  Of course his peers were never educated about his stuttering problem but perceived him to be exempt from responsibilities and expectations thrust upon them.  He got some teasing and disparaging remarks about it from time to time.  I am not saying that faculty should have announced his preferential treatment. I am saying he should have been coached and supported to make all the talks in front of his class.  The phobia that was enabled blew up in college.
  • Character voices:  several years ago I thought that comedian/actor Jim Carey had been cloned.  I had a number of young boys imitating his voice and mannerisms.  They had discovered that they could sound more fluent and make people laugh. This attempted solution becoming a problem had extra appeal – laughter and approval. Many preschoolers have discovered that whispering and character voice can seem to eradicate stuttering.  Since avoidance of stuttering is simmering under the surface, the tricks usually last for only a short time before a new one is needed.Some with severe and chronic stutters have reported being shocked after experiencing fluency in a school play or theater performance.  Stepping into a different character role, one that doesn’t identify himself as a stutterer, can sometimes manifest startling fluency. It is not recommended to speak in character voices to conceal stuttering. This attempted Jekkyl and Hyde existence is not healthy. It does raise questions about how a person, when not thinking about stuttering and rather focusing on a character role, can remove stuttering from his speech.

    Real Solutions

    In the Deep South there is an expression: “if you always do what you’ve always done, you’ll always get what you always got.”   The definition of insanity is to continuing doing the same thing over and over again but expecting different results.  Trying to not stutter- with all of its physical symptoms of struggle and avoidance tricks- is a recipe for insanity.   I did it for more than 20 years.

    Parents and speech-language pathologists (SLPs) have to intervene and assist young children as they abandon Fight and Flight.  Again, this is the best time to resolve stuttering since children have not developed stable memory and do not personalize stuttering and label themselves as older children do.  The leading-edge direct model I developed to stop stuttering in preschoolers is called F.A.S.T. Fluency, an acronym for Family And SLP Treatment for Fluency.  See www.stuttering-specialist.com

    After age seven there are usually cognitive and affective issues that compound the physical symptoms of stuttering.  SLPs have referred to this as the “ABCs of Stuttering”: Affect, Behaviors, and Cognitions.  I have found cognitive psychology strategies from Neuro Linguistic Programming (NLP) to offer a modality for removing anxiety and fear.

    For example, NLP offers therapeutic strategies for “editing” memories of past stuttering events (Bodenhamer & Hall, 1999).  This is not brainwashing, rather it is changing the meaning the person assigned to the event.  One 13 year-old said: “I stuttered when I gave my oral presentation at school….all the kids thought I was stupid.”  This presuming to know what others think is called mindreading. Being convinced that others will think we are stupid if we stutter, could be just the cognitive distortion (Burns, 1989) motivating avoiding and word changing- flight.

    By taking the hurt out of old moments of stuttering, anxiety in the present and predictions of future problems are reduced until eliminated.  So, when you think about it,  NLP and cognitive psychology may be the solution for the PTSD and stuttering comparison.  If you remove anxiety from people who stutter, will they continue to attempt solutions like word changing, phone avoidance, point to menus instead of speaking, avoiding drive-thru-windows, and all the other maladaptive choices?  The answer is NO.  I have found that is possible to eliminate avoidance and other behaviors by integrating cognitive psychology into traditional speech pathology.

    Bibliography:

    1. Bodenhamer & Hall (1999).  The User’s Manual for the Brain, Volume I.  Wales, UK.  Crown House Publishing
    2. Burns, David (1989).  The Feeling Good Handbook.  New York, New York. Penguin Books. pp. 8-11
    3. DiLollo, Manning, and Neimeyer (2003).  Cognitive Anxiety as a Function of Speaker Role for Fluent Speakers and Persons who Stutter.  Journal of Fluency Disorders.  Volume 28, Number 3.  Elsevier Publications
    4. Guitar, Barry (1998).  Stuttering: An Integrated Approach to Its Nature and Treatment. Baltimore, MD.  Lippincott Williams & Wilkins. pp.110-126
    5. Mackesey (2002).  More Than Meets the Eye Contact Aversion. Perspective in Fluency Disorders.  April 2002.
    6. Nicolosi, Lucille (1989).  Terminology in Communication Disorders.  Baltimore, MD.  Williams & Wilkins.
    7. Starkweather (2003).  Stuttering as a Variant of Post Traumatic Stress Disorder.

    ISAD on-line conference.  www.stutteringhomepage.com

    Note: Bob Bodenhamer’s book Mastering Blocking & Stuttering: A Cognitive Approach to Achieving Fluency is now available. Click on the title to read more about the book and how to order it.

    Author

    Tim Mackesey, PC, CCC-SLP
    770-399-5455
    1874 Independence Square
    Suite B
    Dunwoody, GA 30388
    fluency@bellsouth.net
    www.stuttering-specialist.com

Filed Under: Articles by Tim Mackesey

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About Dr. Bodenhamer

As an International Master NLP Trainer, he offers both certified training for Practitioners and Master Practitioners of NLP. He has a private NLP Therapy practice. Dr. Bodenhamer has served four Southern Baptist churches as pastor. He is now retired from the ministry.

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