Monday, December 11, 1995

Comments on a Parents' Manual

In response to a Parent Manual that characterizes stuttering as an "awful" problem

My main point is that it doesn't lay the groundwork for the "acceptance"
part. The old dichotomy "accept but work on changing..." is probably
good for parents as well. In spite of your splendid results there is
still the chance it will become chronic and both parents and child will
have to live with it. I agree this stage is not the right time to tell
them it wouldn't be the end of the world, but it may be the case that
some appropropriate euphemism might do more than just allay sensibilities.

Something like "a problem whose lifelong challege cannot be underestimated"
... a mouthful but sort of the idea. Has John Alhbach seen this? I'd be
curious of his reaction, given his fundamental acceptance position.

Interestingly, and in support of your present writing, my wife loves your
pamphlet as well, and has said nothing about the "awful" characterization.
I am sure she agrees (as deep down I do too...). So, it's worth a thought,
but certainly not much worry. It just leaped out at me and I thought I
should mention it. The important thing is to help the children, and help
the parents help the children, as you are doing so well.

Wednesday, November 22, 1995

More on SLPs

I just want to make sure my posting is not misunderstood. IN NO WAY do I mean to imply
that SLPs are not in the best position to become stuttering therapists,
should they wish to do so (as most or all SLPs on this list obviously have).
They are probably also in the best position to diagnose speech problems.
The way I'd like to frame the discussion is "is there room for some who
are *exclusively* stuttering specialists", probably with an overlapping
but different background, and "how do we (both PWS and SLP) guard against
malpractice from both these hypothetical specialists and SLPs that choose
to treat stuttering.

To use an analogy, civil engineers are certainly best suited to become
good architects, yet, while overlapping, an architect's background
focuses on different aspects of construction. Good construction inevitably
requires BOTH sets of skills. Both professions have bodies that guard
both ethics and quality. A good architect also knows when to send
a client to an engineer and vice-versa.

Tuesday, November 21, 1995

Questions about the SLP profession

We talked about a stuttering specialization for SLPs. Now I want to ask
something that is bound to generate some heat ... can one become
a "stuttering specialist" WITHOUT becoming first an SLP? I am
interested in both issues of potential effectiveness as well as legality and
peer recognition.

First of all, I believe that there are already people in the profession
who are not SLPs and some are well known (am I right?). Whether or not
they are well regarded by SLPs is not the issue (or is it?). I simply wonder
whether it is really necessary to learn about other speech and hearing
impediments in order to become an effective stuttering therapist.

My reasons for asking are both "academic" and personal. On the academic side
is my belief that stuttering is fundamentally different from, say, aphasia,
and, as I expressed in other posts, studying neurology and psychology might
be actually more relevant to the stuttering problem. My personal reason
is simply that I have given thought to becoming a therapist but I am
exclusively interested in stuttering. Yes, one can pay "one's dues", but,
as anyone at my stage in life will attest, I feel I have already spent
most of my life "paying dues" and, at 50, I have very little patience
for dealing with stuff that doesn't go right to the core of what interests
me.

Granting that, to some extent, we always bring all of our background to bear in all our endeavors, how much of a typical SLP's academic and (non-stuttering)
therapy background REALLY comes to bear on stuttering therapy? How much
is "paying dues" (if you are only interested in stuttering)?

Blocking and the "Valsalva maneuver"

(In objection to blocking being caused by a stoppage of air-flow)

I once heard Bill's (Bill Parry) presentation. I was and still remain skeptical.
To me the "block" is in the "control system" that moves the
articulation along from one phoneme to another. It doesn't come
from "cutting off air". To use an analogy, suppose I am playing the
saxophone. One could stop me from going on with the music simply by plugging
up the air duct (Valsalva, if I understand correctly) or by paralizing my
fingers. But wouldn't sound still come out if I kept blowing with my
fingers paralized? That's where the analogy breaks down. In the case of speech,
"finger movement" would feed back (my educated guess) and determine how
much blowing is being done. So the whole system comes to a grinding halt,
but NOT because something just plugged up the air duct. I realize this
is mere speculation, and I am not sure if any therapeutic consequences
would come out of this, but it would be great to devise and experiment that
puts the issue to rest.

There is actually an observation that, IMO, puts the issue to rest. Some
blocks come with "sound" behind them! Unless I am dreaming, I have often heard
stuff like hmmmmmmmmm, hmmmmmmm, hmmmmmmPOLICY, for someone blocking
on the "P" of "policy". So air is actually flowing, just like it would be
for the "finger paralized" sax player.

I have pointed this out a few times on the list and never got an answer.
Will somebody please either agree with me or tell me why I am wrong?

One last point. I do NOT mean to carry the analogy to imply that some
form of vocal cord "paralysis" is the fundamental cause. Again it's the
sequence of articulatory commands from the brain that gets "stuck"
(my opinion and that of many).

Monday, November 20, 1995

Stuttering in a foreign language

In this post I was asked several interesting questions by Larry Molt. I will paraphrase his questions and post my answers

Yes, even though initially I was not recognized as a stutter I did experience stuttering exactly the same way I experienced it in Italian.


Yes, I experienced the same stuttering patterns (block etc.)


No, stuttering did not happen to the same extent as in Italian and it also went unrecognized because it was misinterpreted as a difficulty in speaking a foreign language. As you conjectured, I was also speaking slower, with shorter phrases, more pauses etc. probably reducing demand on my speech and therefore reducing stuttering.

Eventually the reason for lessened stuttering vanished with increasing "fluency" (yes, I was struck by the same conundrum!... more stutter the more "fluency" in the new language). Interestingly the first statement is true to this day. In my mind English, at this point, is actually easier than my native language, but I still do have a slight accent, and when I have one of my now rare blocks, people tend to think that "I'm hunting for the word". Given different situations I've had to choose between being thought of as
"just off the boat" or as a stutterer..

I think my experience does match yours (ironically, stuttering more with increased "fluency" in the foreign language). Interestingly it was also confirmed
in an acting class I took. As I was learning a part, I was better able to
avoid stuttering than when I had completely "interiorised it" and had begun
"being" the character I was portraying. The director asked me why I had chosen
to "make" the character stutter! He was baffled when I told him it had not
been an "acting" choice.

Is my child a stutterer?

Hi Woody,

My 3 1/2 year old child, is beginning to show occasional signs of "stuttering"
that go a bit beyond "normal" hesitations for that age. I am not overly
worried and he has shown no signs of frustration. He LOVES to talk and
his chatter is incessant and quite fun to hear. In the past I would have
just waited, but, given the information you have put on the list, I do
view him as "at risk" and I would like to have him undergo whatever
therapy might be appropriate at this point.

Is there any clinic/SPL in the San Francisco Bay Area, that would approach
this type of therapy along the lines you have been developing?

I'll appreciate any suggestions.

Thursday, November 16, 1995

Stuttering in biligual children

Does the "capacity and demands" model imply a higher incidence of stuttering in bilingual children?

I am betting my own child's life experience on "no"! I think "demand"
refers to "speech mechanics" performance, not a knowledge of alternative
ways to say things. He is simply learning that mother says "milk" and
"papa'" says "latte", so when he talk to me he asks for "latte".

If I can use an analogy, would you worry about cognitive overload if you had
a vacation house and you child had to learn to find his way around two houses
instead of one? He would learn that the kitchen is on the left in house A and
on the right is house B. "Demand" would be equivalent to asking him/her to
move faster in either house...

I sure hope I am right...!

Wednesday, November 15, 1995

Why I joined the NSP

Ira Zimmerman commented that people who have largely overcome stuttering should perhaps form a separate organization (NSP stood for National Stuttering Project - the name was later changed to NSA)

granted that one could claim that "everything" we do is to meet some
need... I joined the NSP more to see if I could help than to find
"support" for a problem I felt I had largely overcome. Maybe this
was presumptious on my part, but it was my original motivation. It
turned out that I still received much more than I gave. Some of
what I received can be described as follows:
1. A sense of "coming home", embracing where I had been. Note that
until then I had always avoided other stutterers...! Interestingly I
had fully accepted (or so I thought) MY stuttering, but hearing others
stutter brought back too much pain... until I joined the NSP. This
was perhaps one more phase of healing I didn't know I needed.
2. Absolutely wonderful new friends. People like John Ahlbach and John
Harrison! And many others.... I see them rarely now, but when
I do it's like meeting family.
3. New and continuing insights on stuttering. Some that I am still
applying to myself, and some I can share with others (including
this list). On and off I toy with the idea of becoming a Stuttering
Therapist.
4. Surely much more than I am aware of.

"If you stutter you are not alone" is the NSP motto. I did grow up
"alone" and I wish I hadn't. The stuttering of each one of us takes
different paths, but none of us has to face it alone, ever again. I thought
I'd join to give support and embrace those who were still
struggling. It turns out that I embraced my "child" and that everyone
embraced me. Are you still puzzled Ira?

Bilingual stutterers

In response to a comment about the possible deleterious effect of bilingualism on suttering

I am a bilingual stutterer, and now father of a child I am encouraging to
become bilingual.

I was born in Italy and came to the US at 16 for one year, then again
at 20. At first I was not recognized as a stutterer in this country, but,
as I became better and better in English stuttering became evident
again. What I think happened is very simple: my hesitations in a foreign
language simply masked my stuttering. I must confess that for a while
I found this very convenient... it was much better to be thought of as
foreign struggling with english than as a stutterer!

I have also felt that Italian requires somewhat faster vocalization for
the same rate of speech, as words are generally a bit longer, so I retained
the feeling that I stuttered a little less in English. This observation is
however clouded by the fact that I have worked at overcoming
stuttering and I no longer view it as a problem in my life. The same
might have happened if I had stayed in Italy.

I am the father of a three year old, whom I consider "at risk" for
stuttering.nevertheless I decided to speak to him only in Italian. He hears
English from everyone else. I don't view this as extra potentially
deleterious "pressure". To him it's just an alternative way to say things and he seems
to be enjoying it.

Monday, November 13, 1995

Specializing in stuttering therapy

To a therapist claiming that it's not "good" to simply specialize in stuttering (he'd rather work on a broad range of speech problems).

Why not if it DOES work? There is something to be gained from "holistic"
approaches, in fact MUCH to be gained, when the areas considered have a
fundamental bearing on each other. The "specialist" in stuttering might
well have to be a generalist in neurology, psychology, phonology etc.

I feel that sometimes we are stuck with classifications that are based
on old fundamental misunderstandings about problems. The appropriatedness
of classifying stuttering with many other phonation problems should be
revisited in light of what we are beginning to understand.

Please note that I speak as a stutterer, not a SLP, and I have no specific
knowledge to make me doubt that you have personally been very successful in
working with stutterers. I can only say that, as a consumer, and given
the simple fact that so much therapy is ultimately unsuccessful, I would feel
much more comfortable knowing that my therapist or my son's therapist is
totally focused on, and knowledgeable in, the peculiarities of this stubborn
problem.

Thursday, November 09, 1995

The scientific value of testimonials

In response to a comment by Ira Zimmerman stating that there is no scientific backing for most claims of "recovery".

I am one of those people who tends to talk about stuttering as *mainly* a thing
of the past, and has given "testimonials" on his recovery process. I think
both Ira and Jason bring up good points.

The fact is, I DON'T know if I got better because of my efforts, or aging
would have done it for me anyhow. I DON't know if what I have been doing would
have been equally successful had I started off with much more severe
stuttering. When I talk about my "success" I can't help having a nagging
feeling that, in spite of what I think, my problem and, say, Ira's, were
quite different. My very first contribution to this list was in fact
a thread that dealt with the possibility of two different "kinds" of stuttering
(I mean both recognized as developmental but arising from different
causes, although "appearing" to be the same problem on a continuous severity
scale). I even asked if there were bimodal distributions on any stuttering
"metrics".

The best answer I got was Woody's, who stated that, in his experience, "severe"
stutterers often seemed to make rapid progress in therapy, only to relapse,
while "mild" stutterers made much slower but stable progress. I think there is
something really worth looking at here....

All this being said, I, John and others are simply data points. If somebody
claimed to have improved by making back-flips, that would be a data point
too. It's up to whomever wants or can to use these data points and make
some rigorous science out of it. So, no, my own testimony IS NOT GOOD ENOUGH,
but together with that of others it may enable some useful model to be built.

I really wish I could have been part of a rigorous test. If anybody thinks that
they can do something with me now... come and take me, I'm yours!

Thank you, Ira, for reminding us that just because we say it is.. it doesn't
make it so.

Wednesday, November 08, 1995

The brain and the hardware/software analogy

I just want to make the point that the hardware/software analogy with
some kind of "fixed" brain on which some kind of "programming" (presumably
environmental/psychological) is imposed, is VERY limited and perhaps even
misleading when it comes to language development.

First of all, when it comes to neural nets, both biological and artificial (my
field) program and hardware cannot be separated. The "program", which can only
be defined as interaction with the outside world, becomes inextricably connected with the hardware. In a regular computer you could erase the program, and the
hardware would remain, unchanged, and ready for a different program. Even with
the very simple neural nets we build, it is not possible to separate the two.
Changing the program means modifying the connection strengths between neurons
AND adding or eliminating neurons and connections. So what are we changing, the
software or the hardware?

Second, the way this kind of "programming" is realized in the brain is itself
the result of "primitive hardware", it therefore not immune from the results of genetic coding. Early hardware + early interactions become new hardware, which
then becomes sensitive to new interactions (...a different level of "programming").. and so on.

I often stand in awe on how similar we all are in light of the extraordinary
complexity of our development. The point is that evolution has built a very
robust system, capable of building two eyes, two legs, a single nose etc. under
an extremely varied set of conditions. The same goes for our speech apparatus, a far more complex system than any single organ. I am baffled at the resistance
I keep seeing re-emerge to the notion that some "organically" based process
within this system might not be up to snuff. Even ignoring the abundance of
genetic studies that show a clear link (but why ignore it?), it is the amazing
specifity of the problem (even though each one of us "dances" around it in
different ways) that convinces me of a fundamental organic cause.

I am equally convinced that psychology DOES play a role. Faced with an obvious
problem, we try to overcome it or work around it. Our particular psychological
makeup can either help us or make things worse. Fear, self-confidence,
determination, acceptance, all play a role in how, if ever, we are able to
CONTINUE the kind of "programming" I discussed above. Even though our neural
pathways, at least at the level of basic systems constructed early on, are far
less plastic, we still CAN improve. Stuttering has ceased being an issue for me. I don't know if my early pathways have been modified, or if I built some good
workarounds, or if that unwelcome continuing program called "aging" had in
store some relief for me anyhow. I do know that I have worked at it, and that
my particular psychology has helped, but I might have done better sooner if
somebody had given it a little push once in a while.

Learned behaviors and evolution

In response to a note remarking that learned behaviors (such as acquired musical skills or maladaptive stuttering behaviors) could be passed on by evolution.

I haven't read "The beak of the Finch", but I do know that Darwinian evolution
does NOT allow for such a mechanism. This was precisely the debate between
the Darwinians and the Lamarkians (sp?). The former explaining evolution via
chance occurrences the latter as guided by environmental "drive" or "need".
A mechanism for the former was found (the genetic system) but not for the
latter (still, I believe). But this does NOT mean that it is conceptually
impossible. We are, after all, the result of evolution, and we are now doing
precisely that, when we do genetic engineering. The point is that we are now
able to figure out, at least in a few cases, what genetic changes are required
in order to produce desired results. It is very difficult to imagine how
nature could do that simply at the level of the body i.e. without the
social/scientific evolution that allows for our ability to build "models" of the genetic system.

Computer "do" that only in the sense that the programmer knows (or should
know) how to change the code in order to obtain desired effects, but even
they often find it hard to do (ever heard of bugs?). In terms of neural nets
or artificial systems that learn and evolve without conventional programmer's
help, the ability to combine both kinds of evolution (chance and goal direction)
is an open area of research (one I am involved in, by the way).

Monday, August 14, 1995

Maintaining eye contact during blocks

Victoria Schutter said that one would have to be "psychotic" to maintain eye contact during a block.

I agree with these sentiments. The first fight (amicable) I had with a SLP was about this issue. I WORRY about my listener when I have a block. They already have to put up with my inability to say a word (while resisting the temptation to finish it or guess it..) and now they have to put up with my unwavering stare that says "I know I am having a block, but I dealing with it and I want you to STAY with me". I say, give them (and yourself) and break!

So my listener gets tense... guess what that does to MY tension. Eye contact is part of the communication process and should be approached (IMHO) in the same relaxed fashion as the rest of speech. Let it be a byproduct of increased comfort, not another THING to do. Be aware of both looking and not looking and let both happen naturally. If it feels right to avert your eyes and let your listener "relax" do it. If your listener shows no sign of discomfort and seems more intererested in what you are saying than how you are saying it, then by all means maintain a natural eye contact. The basic problem is that eye contact for the duration of a serious block is no longer "natural" eye contact. I fear that it appears as "disfunctional" as the block itself - that is how it appears to me on the other side..- and it may in fact make the block seem even worse. As would of course shutting your eyes, repeated blinking etc.

This is one more case where there is no easy answer or recipe in stuttering, just the usual apparent contradictions we all have to sort out for ourselves (with the understanding help of SLPs)... accept in order to improve..., maintain control so you won't have to keep maintaing control... and so on.

Monday, August 07, 1995

"Critical Thinking"

In response to Michael Sylvester after his note on 8 "critical thinking skills" directed at another post


I would add to these the need to

9. Avoid diversionary tactics such as
- banter
- trivialization of others' point ("Stuttering Kaleidoscope", "Neurological
Talk Soup", "Neurological VOODOO")
- "teaching how to think"
- Picking and choosing minor points to answer while ignoring the main ones

10. Retain a sense of common purpose and seek points of agreement as well as
disagreement.

I have found myself growing more and more impatient at your postings for the
abundance of both #9 and #10 tendencies. I found myself spending a great
deal of time for thoughtful answers, questions and attempts to validate your
experience as a PWS who has made a great deal of progress, only to see
minor points picked up and potential conclusions obfuscated by banter.

I was particularly disappointed in seeing no clear answer to my posting
where I tried to establish some commonality between your experience
and that of myself, John Harrison, and probably that of many other
stutterers who have achieved a great deal of (or "complete") fluency.
The important point here was that, even seemingly different points of
view often turn out not to be so dissimilar after all, and there are
important lessons to be learned both by other stutterers and SPLs,
whether or not we agree that the evidence for a neurological basis of
this disorder is compelling enough.

It is extremely important, in my opinion, that this list not be a forum
for matching wits, rather an honest and continuous attempt to find elements
we can use, both in terms of therapy and as well as potential causes.
I feel that you have done so several times, and obviously many others
have thought so as well, or you wouldn't have received so many thoughtful
answers. I invite you to keep up the standards of these postings and
to help us maintain the climate of earnestness and respect that has been
so typical of this community.

Friday, August 04, 1995

The effect of stress on stuttering

In response to a note by Marty Jezer on the effect of stress on his stuttering.
He feels that stuttering has neurobiological origin, but that psychological factors, in the form of stress, contribute to "setting off" stuttering.

What you say makes complete sense to me. It is in fact the key to my
own "recovery". I spent years becoming aware of the subtle stress
in my body that was generally associated with "increased probability"
of stuttering. I took blocks not as "things" to be individually
examined, but as "alarm bells" of generally increased stress that
I had to bring under control. General stress awareness can be achieved
also in other endeavours such as classical singing and dance. I did
these too and they helped. I had long exchange with John Harrison
on these ideas here, a few months ago.

The point to be emphasized again is that stutterers are not any
more prone to stress than anybody else, but simply that it affects
our speech apparatus, whereas fluent speakers are not affected the same
way. Extra stress vigilance is our form of "insuline". The consolation
may be that we'll get more fluency and a "stress free" life at the same
time (we may even end up living longer... which would be a fair way to
make up for all those disfluent years!!)

Thursday, August 03, 1995

Discussing the "biological appraoch"

In response to Michael Sylvester's skepticism on the biological approach to stuttering "on what chromosome is the gene for stuttering located?"

Genetic links are typically established long before genetic sites can
be found. Here is a notion that keeps coming up in very strange ways.
Whether or not one supports it (and I do) it should at least be understood
clearly. There is no "gene" that will make you "stutter on the word
pumpkin..." or any specific situation (Michael, you did not say this, but
others recently have in this context). Genes are simply "blueprints" for
something that gets constructed by the body. This "something" gets
constructed once, starting with conception and through gestation and
development, or it keeps getting produced throughout life like some needed
protein. People whose genetic defect is low production of insulin, for
instance, have difficulty processing sugars and are called diabetic.
They don't have a gene "for getting sick when they eat chocolate".
We know that the speech apparatus is very complex.
Stuttering may arise from relationships between different parts not being
quite right and prone to "breakdown", somewhat like an engine that tends to
stall when the temperature is too high or too low. In this case there may
never be a "gene for stuttering". The complex interplay of genes that are
responsible for the contruction and maintenance of the apparatus would be
"responsible". It may also be that our tendency to "breakdown" is simply
due to the lack of some simple chemical. In this case a gene site could
eventually be found along with a cure based on drugs and/or genetic
engineering.

In response to Michael's note that there is lack of consistency in stuttering, as
stutterers do have periods of fluency (this would seem to contradict a biological cause)

Ever had a car that tended to break down more that others? It still
had periods in which it took you to work.

He notes that environmental and psychological factors
can have an affect on physiological systems.

Of course they do. My mother saying to me "stop it" and slapping me
for stuttering probably made it worse... until I could understand what
was happening, forgive her, forgive myself and proceed on my life-long
path to better and better speech.

Wednesday, August 02, 1995

Biology and "volition"

To Michael Sylvester about the role of volition

"Biologic", "Neurophysiologic", "Genetic" ... what have
you... by no means implies "helpless", or that volition can play no role.
I have WANTED to stop stuttering all my life and I have WORKED at it,
as you have. By saying "eventually" it seems to me you are admitting (as
I think you have before) that "just say no" is not an easy quick fix. So are
we really disagreeing or is this just a semantic issue (as John H. suggested).
I generally like the way you name some concepts. "sustained automaticity"
is one example... and, if I understand it, it's exactly what I think
I have achieved. The only difference from your thinking (if I understand)
is that you seem to imply that the problem I worked so hard at overcoming
had been "created" by myself in the first place. I, and many others,
believe that, however you want to define it, a "weakness" was present in
my speech apparatus for me to deal with. I could have lived with it
or I could try to find some way to work around it (and I did, using
"volition" too).

Just because squinting your eyes can bring things into focus doesn't
mean you created your own sight problem! Just because squinting can
become the result of "sustained automaticity" does not mean you did
not have a sight problem. Yes, I remain hopeful that the equivalent
of unubtrusive glasses or eye surgery may at some point make all
these discussions obsolete.

Just say no?

In response to Michael Sylvester's definition of "voluntary" as any "self-initiated behavior performed, which upon "post reflection," allows for the possibility that one had the choice to perform or not perform that behavior."

And by that definition you view blocking as voluntary? I would have to be
aware of the possibility of blocking (and choose not to..) at the
beginning of every sound I am about to make... I am afraid that would
put a serious damper on my communication (and pleasure in it). This
is not like choosing to eat chocolates or not..

Response to Michael's comment on some people's recognition of the therapeutic value of some of his propositions.

Nobody who has commented on your views has denied the therapeutic value they
had on you. Several, including myself, have commented positively on the value
of the block management ideas you have expressed. I also mentioned that
if a "just stop it" attitude worked for you, it may work for others, and
that's a good thing for everyone to know. As Chris Stephens cogently pointed
out, this is quite different from an endorsment of causality. If volition
were the simple cause of stuttering then chronic stuttering would be
a psychological problem. Far from a "mythical idea" this has caused
great harm to our community and has taken centuries (millenia?) to
debunk. The notion of resurrecting it "for therapeutic value" as a way
to emphasize that we do have some control over our speech, may, I state
again, have some value for others as it apparently had for you, but,
far from "user friendly", it could also cause great harm, and, in this context, I would recommend that any SLP exercise EXTREME caution in adding this to their "bag of tricks".

I also see danger in the resurrection of this notion in the media. I can
just see a 20/20 segment: "Stuttering Solved... just say no!".

Tuesday, August 01, 1995

To block or not to block

In response to Michael Sylvester's about becoming aware of "internal states that make blocking more likely". "In the final analysis - he says -one can reach the stage where the big question is TO BLOCK OR NOT TO BLOCK!"

If you mean that one can work on creating conditions that will make his/her
blocks less likely, I agree. If you mean that when I find myself in the
clutches of a bad block somehow it's because I "decided" that this time
I'd just go ahead and block... I don't agree.

He comments that he was a "severe stutterer" because he used gross muscular movements to release himself out of blocks.

By that definition I was a severe stutterer too. I once asked a lady for
directions in Boston and I blocked so severely that she thought I was
undergoing a Dr. Jackill (sp?) to Mr Hide (sp?) transformation. She almost
fainted ... I almost did the same out of embarassment.

I suspect this is not, however, the single factor clinicians, and most
stutterers would use to judge severity. I can see how your "diary" method
would work in this case, but, as others have pointed out, when you stutter
on practically every word (or sound) it's a different story.

Let me ask something else that I may simply have missed (sorry if this
is the case). Have you had much contact with other stutterers? If I think
back, it's amazing how little contact I had until I joined the NSP. While
growing up I thought I and an older cousin were the only ones in the
world. Later I avoided other stutterers. In all I have to admit that I had
NEVER heard really severe stuttering until about 10 years ago. I am now
50 and I credit the NSP with allowing me to get over my overwhelming desire
to avoid other stutterers... and in fact opening me up to new ESPECIALLY
wonderful friendships, besides a deeper understanding of the problem.

I continue to find that your "just stop" attitude, motivator, hypothesis...
whatever...is potentially harmful both from the point of view of engendering
"etiology confusion" and most likely providing more continuing frustration than therapeutic help to many. On the other hand, if it helped you it CAN help
others, and, in this context, I am very glad you have been expressing it. I also find that your block management ideas are good. This is one of the wondrous
aspects of this field that has been shown time and time again on this list. Even
completely different and conflicting cause postulates often result in similar
and effective therapeutic ideas.

Friday, July 28, 1995

The "Scatman" CD by Scatman John Larkin

(Lyrics posted be Darrel Dodge)

SCATMAN (Ski-ba-bop-ba-dop-bop)
by Scatman John Larkin

I'm the Scatman
I'm the Scatman

Everyone stutters one way or the other
So check out my message to you.
As a matter of fact don't let nothin' hold you back
If the Scatman can do it, so can you.

Everybody's saying that the Scatman stutters
But doesn't ever stutter when he sings.
But what you don't know, I'm going to tell you right now
That the stutter and the Scat is the same thing.

You know I'm the Scatman.
Where's the Scatman?
I'm the Scatman.

Why should we be pleasin' any politician's reason?
(They) would try to teach us reasons if they could.
The state of the condition insults my intuition
And it only makes me crazy, and a heart like wood.

Everyone stutters one way or the other
So check out my message to you.
As a matter of fact don't let nothin' hold you back
If the Scatman can do it, brother, so can you.

I'm the Scatman.

I hear you all asked about the meaning of Scat.
Well I'm the professor, and all I can tell you is
While you're still sleepin' the saints are still weepin.'
Those things you call dead haven't yet had a chance to be born.

I'm the Scatman.

Wednesday, July 26, 1995

Are stutterers responsible for their own stuttering?

In response to a post by Michael Sylvester where he essentially states that the stutterer "causes himself/herself to stutter"

It's taken me a while to sort out my feelings about your statements. They
have run the gamut from anger to complete puzzlement to, interestingly, some
foundation of agreement.

First of all "your" idea is far from radical. My mother, with an elementary
school education, would say to me EXACTLY the words you used to start you
on the path to recovery: CUT THAT OUT! She would say that in Italian and
would often accompany her admonition with a hefty slap on my face.

What has been completely puzzling to me is that a Ph.D. psychologist AND
former stutterer would subscribe to the same principles. Maybe the pendulum had swung too far in the direction of "helplessness" and it's time to rethink the
role of personal responsibility. Point noted.

Again, this point is hardly controversial. Many of the discussions that have
gone on on this list have been centered on the "actions" we as stutterers
have taken to gain "control over" or "recover from" stuttering. I had a long
argument with John Harrison, for example, on the "nature" of blocking and
on the appraches that seemed to have worked for us (I consider myself
practically "recovered", and John certainly is). We certainly agreed on the
notion that there was SOMETHING we could do to get better and better at
avoiding blocks and we certainly had the WILL to start the process. We also
agreed that the process took time, and for some it might never quite "end".

These areas of agreement, it seems to me, extend to parts of what you are
expressing, but they are a far cry from implying that the process of recovery
consists of undoing - mainly by willpower - something that we somehow
"chose to do".

You seem to be making two separate independent assumptions:

1. We "choose" to start stuttering just as we would start smoking.

Could you elaborate on what "returns" this choice would provide a 3 to 10
year old?

2. Anything we chose to "do" we can "undo" with equal ease.

EVEN IF, for some misterious reason and warped reward, we actually CHOSE
to start stuttering, why would stopping be any easier than, say, quitting
smoking?

Whether or not you decide there is an "IT" to be blamed or fought out there,
the very fact that, at some point, you had to say to yourself "CUT IT OUT"
IS the problem. Fluent speakers don't have to do that. With a little bit
of attention, in Toastmasters they learn to avoid saying "Ahs" , no
traumas, intensive therapy, no relapses. Now, THAT, is just a bad habit
that can be simply willed away.

Unfortunately it is often very difficult to separate fact from perspective.
Did I will my stuttering away or did I build a good strong mechanism to
compensate for it? I do respect the fact that your perspective enabled you
to overcome your problem. Now, can you help us figure out some way to test
whether we really DO "choose" to stutter?

Do you have the same perspective on other "alleged" mental ailments? Depression
in its various forms and Tourette syndrome come to mind. Can they be willed
away as well? If not, what makes you think that neurological problems could
affect mood but not speech?

A final doubt always haunts me whenever I use my own experience to generalize
to all stuttering. I have brought it up a few times in some feeble attempts
to find out if there really is ONE stuttering problem. Granted.. highly
individualized etc., but fundamentally the same problem. Maybe "mild"
and "severe" stuttering have completely different causes, but just sound
like they only differ in severity. Doesn't pneumonia sound like a very
bad cold?

Tuesday, April 04, 1995

Kato Kaelin

Kato Kaelin is an actor who became known as a friend of OJ Simpson during the infamous trial... As he spoke to the media, some people thought he was a stutterer. Woody Starkweather though that he was NOT a stutterer.

Woody, I must defer to you as SLP for a diagnosis, but I confess that
I am a bit surprised at how definite you sound (in spite of a very
minor qualification).

My impression is that it is also a common layman's misperception that
a highly disfluent "normal" speaker is NOT stuttering. Even blocks
are often not recognized as "stuttering" by most people, let alone
word substitution.

I came to a different conclusion (but I am far from sure) in a rather
peculiar way. I was driving home, and I started hearing on NPR what appeared
to be a very disfluent speaker trying to tell a children's story. No repetitions
or evident blocks but stuff like "hmmm ... not-a-boy ..hmm ..a.. girl..".
Far from finding it amusing I found myself getting very angry. Here we
go again, I thought, ..making blatant "fun" of a stutterer! I was already
planning to send a message to Ira asking him if he new anything about
this stupid skit when I realized this was a parody of Kato Kaelin!

Now, I haven't followed the trial much and I haven't heard more
than a few seconds of the "real" Kato. But... sure enough, the notion
that he might be a stutterer had occurred to many others on this list.
Let's not forget he is trying very hard to be an actor, and he's
probably under enormous pressure to mask any stuttering any way he
can. It wouldn't surprise me if he found that hesitating and substituting
words is a much better way to go than appearing to stutter. There are
probably not many directors that would risk giving a part to a stutterer.
His kind of disfluency on the other hand (they would probably think)
would be esasily remedied by a good script.

Why is this important enough to discuss? Because perhaps he could
use "our" help, and because, if he does turn out to be a PWS, this
could be a good chance to "educate" the public on the peculiar
forms stuttering can take. In any case, whether he is a stutterer
or not, we should react forcefully against anyone who feels the
right to make fun of him (of course having PWS come to his defense
may be the LAST thing he wants...). Is there anyone among us who
could get the story from him? (Any idea Ira?)

(Referring to Ira Zimmerman who was the self-appointed media "watchdog" of the stuttering community)

Wednesday, March 29, 1995

Core behaviors

In answer to comments by Woody Starkweather on core behaviors

A few points:

1. I am glad you agree that this deeper or initial "core" is a key to
understanding stuttering and to early therapeutic intervention. In this
case let me be less shy about suggesting that a good name be attached
to this concept in order to distinguish it from "traditional" core
behaviors. Thinking produces language and language produces new thinking.
Labels ARE important!

2. Assuming an "initial core" a transient state and a final steady state
("traditional core" ... my modeling background is showing), then lots
of research questions come up. How long is the transient? This the
period during which we learn our own very personal way of stuttering.
Months? Years? How malleable do we remain and for how long? I have been
always struck by the notion that learning a second language before about 11
years of age (in the new country) all but guarantees the ability to have no
accent, while after that age it's always a long struggle. And my
previous questions: how does coping during this period shape the stuttering
"style"? Is an understanding of how one coped initially and during the
transient a good prognosticator for the most appropriate type of therapy?
There is much work about how one learns language. How DOES one learn
stuttering? (good hints are coming out of your work!).


3. Woody, I was very surprised when I first found out that you were NOT
a stutterer! ... And that's the HIGHEST compliment. I really think that
you and many other (non stuttering) SLPs on this list understand stuttering
>From the "inside out" in a way I didn't think was possible. I find this
very reassuring. I wish there had been such a way to communicate years
ago...

Tuesday, March 28, 1995

Distinguishing "core stuttering" from learned behavior

In discussing stuttering therapies one needs to understand what the therapy addresses, and my point here is that much therapy addresses what can be considered "learned" behaviors.

I said

> In summary, instead of "show me how you stutter and I'll tell you what
> therapy will be best", I suggest "tell me how you have been coping with
> stuttering from the very beginning (i.e. what and HOW you are likely
> to have LEARNED) and I'll tell you what therapy will be best".

Woody S. pointed out that there is the possibility of misunderstandings in how stutterers define stuttering as opposed to how speech pathologists do. Stutterers think of repetitions and blocks as "stuttering" while pathologist often think also of the whole syndrome of maladaptive learned behaviors, such as eye blinking, word substitutions etc.

In answer to his point I wrote:

I was trying to draw a more subtle distinction, and I probably need
yet MORE help before I cause too much damage by clouding the picture
with my own brand new set of definitions.

I am addressing mainly core behaviors, and I am trying to assess how much
even these are the result of "coping". I'll try with some examples, then,
anyone, please feel free to suggest a set of clearer words, if what I
am saying makes sense.

I am a kid, and I suddenly start experiencing blocks. How do I cope with
this event? Some kids realize that they can substitute words, some feel
that they can blast their way through them come hell or high water, some
try to make it come out, give up, try again, give up and get into a long
set of repetitions. At a different level some will feel a great deal
of shame and try to avoid speaking, some will want to speak no matter
what. My point is simply that ALL of these kids will probably continue
to experience blocks but their blocking "style" will have been modified
by how they began coping with the problem.

So now you are the SLP and the kid (or now the adult) comes to you. You
see blocking, you assess its severity and start trying the techniques
you have had most success with. It seemed to me that the discussion
on screening and prognosis centered on the assessment of PRESENT
stuttering behavior. My question is the following:

Assume that two people have blocks of similar frequency and
intensity, but, at least initially, they "coped" differently with the
problem. Would they benefit from different therapeutic techniques?
Could their initial "coping style" be a prognosticator of the best therapy
for them? Are these considerations that enter the minds of SLPs when they
try to asses what to do?

Why am I asking this, and why do I think it might be important?

My hypthesis is that even much of what is viewed as "core behavior" is
in fact the result of a learning process, and that this process is guided
by your initial coping strategies. For instance, when I started blocking I
REFUSED to do anything that seemed "unnatural" to me. This included word
substitution and trying to use force to get the word out. Also, if a teacher
asked a question, ... and a little voice inside said "S. don't open your
mouth... you might be embarassed" ... my arm would go up in the air...
I trained it to that automatically! I was determined not to let stuttering
hold me back. It turns out that these were the right things to do, although
there was no therapist around to tell me that in post-war Italian public
schools. (Now I often ask myself, did I turn out to be a "mild" stutterer
because I did those things, or was I able to do those things because I was
a mild stutterer? But this is a slightly different issue)

In summary, I propose (but I am sure others have thought of this) that what
SLPs call "core behavior" is in fact the result of a learning process that
was framed by initial coping strategies. This initial pre-learning
behavior could be called.. sub-core?.. pre-core ...real core behavior? Help!
I guess we don't need a special word if this is not a useful concept, but if it
is...

Assuming then that a specific set of "coping" (different word needed?)
strategies led the PWS from pre-core to core... could these particular
strategies be better prognosticators for successful therapy than the
simple observation of core behaviors?

Whether or not what I said is useful, I hope it was clear.

Monday, March 27, 1995

Response to John Harrison regarding psychological factors in blocking

In response to John's complaint that the list has been unwilling to consider his proposed explanations of stuttering blocks.

John:

I think you are being unfair. Many of us have spent a great deal of time
discussing this issue with you and, speaking for myself, learning a
lot in the process. I am not sure why this wouldn't qualify as "willing
to explore it" with you, but, whatever it means to you, have you done
so with the "opposite" view?

I have learned the following from your view:
1. Individual word "fears", conscious or subconscious, could play a role in
increasing the tension that makes our speech machinery "break down" (I already
held this view, but you have certainly strengthened it).
2. Dealing with these fears in a psychological context can help "dimistify"
blocking behavior and bring our attention to the whole of speech where it
can be of most use. I would never have thought of doing this. Now I would
consider it a good bet in helping some people.

Now, have you "learned" anything from the "genetic view"?

In response to John's bemoning of the fact that many people "latch onto" timing problems, that we can do nothing about, because they would be genetic in origin.

"Genetic" BY NO MEANS means that you cannot do anything about it! Genetics
is only the initial blueprint. It is followed by an embriologic stage AND
by several developmental and learning stages. One CAN intervene and modify
the "natural" development of any of these stages if one knows what one is
looking for! Even when one misses the developmental stages it is sometimes
possible to find chemical, surgical and yes, psychological "fixes" too.
Treatments for depression come to mind as a good example. We are also seeing
the dawn of genetic engineering. Again the key is to find exactly what we should
be looking for.

My interest in the genetic cause is simply due to the fact that I think
it will ultimately illuminate the most productive course of action in
eliminating stuttering. And NO, John, I am not afraid of appearing
psychologically "weak" by not viewing blocking behavior as essentially
psychological in origin. You can bark all you want but it's the wrong
tree. I really don't give a damn about showing chinks in my armour. I am
afraid of snakes and hights. I have had to admit to myself and others
traits in comparison to which "the psychological load" of particular
words or situations absolutely pales.

In response to John bemoning his own perception that many seem reluctant to explore other non-speech related factor that may be relevant to the problem

Do you really think that people, like many of us, who routinely get up in front
of people "confessing" to be stutterers, would have a hard time admitting
(to other PWSs and SLPs) that some words or situations are psychologically very loaded to them? Loaded enough to cause approach-avoidance behavior? Please
give "us" more credit.

I am glad that you pointed out that none of this means that stutterers are emotionally or psychologically different from fluent folks.... now I can come out and stop this silly
denial game! Come on... do you really think "genetic weakness" is easier
to "accept"? Down (sp?) Syndrome is genetic, and so is a myriad of other
mental and physical conditions people are not particularly proud of.

John, I understand how frustrating it is not to have convinced the many
of us who have discussed this issue with you. I know it is frustrating
to me that the opposite hasn't happened, in spite of the flow of much more
eloquent statements than my own. But, please, simply accept the fact that
your arguments, although eloquent, spirited, and rooted in years of great
introspection, have met their counterpart on the other side. For you
to seek solace in the notion that we are in denial or "afraid" to look at
possible psychological factors, would be the real denial. I am confident
your practice at introspection will prevent you from falling into that
trap.

Sunday, March 26, 1995

Comments on list dialog and invitation to BTF

In response to a message from Janet Ackerman in which I was invited to join the board of directors for the Birch Tree Foundation (BTF).

Thank you very much for your kind words on my contributions. Like many
others, I am sure, I have been tempted to give up in frustration, but
I can't let misleading statements get to the stuttering community unchallenged,
and, curiously, I came to the realization that the fact that I am not a SLP
has given me an advantage in that nobody can accuse me of touting "rival"
therapies for personal gain! You and Woody have been very careful in mantaininga low key objective approach, but I am sure it must be hard at times NOT to
intervene more forcefully and become "censors". I am very glad you have been
able to trust that the PWS and SLP populations would be better served by lettingall opinions be expressed. There would be nothing worse than turning misguided
people into underground heroes.

The silver lining is, I hope, that even long, circular and unresolved
discussions are revealing how the "players" think and are educating people
on facts and methodologies. People who start off with radical positions will
rarely change their view, but I think there is a "silent majority" out there
who has been learning a few useful things.

A suggestion I have is, perhaps, to be a bit more proactive in getting issues
to the fore, so that new interesting issues get to be discussed instead of
being compelled to react to the old ones again and again. Sometimes the best
way to eradicate weeds is to plant a lot of "good stuff" around!

Now, to your offer. I am truly deeply honored that you would invite me to
work with people such as yourselves and the present members of the board!
With the caveat that, at this point, coming by travel money would be a
hardship for me, I would be thrilled to contribute to your endeavor. It
would eventually kill my "neutrality" but what the heck..

Fortunately a lot can be done nowadays with email, faxes etc. and I am
well equipped for long distance collaboration both in my office and at
home, so, let me know what you have in mind!

Wednesday, March 22, 1995

Control and stuttering variability

In response to the point that there is great variability in stuttering behavior

It's hard not to agree with that statement, but what does it REALLY tell
us? Not much unfortunately. Most of all it does NOT tell us that there
are different CAUSES for each individual, but only that there are
different ways of coping, and this is really not surprising. If you
catch a cold your body's immune system reacts, you sneeze, maybe have
a fever. None of these things are under conscious control so all human
bodies tent to react in similar ways.

Speech, on the other hand, is, at least in part, under conscious control
and is learned. It is not surprising then, creative as we are, we'll find
extremely individual ways to cope. If we had conscious control over the
symptoms of cold (or even if we thought we did..) and found that by
hopping on one leg or flapping one arm you could prevent some of its
symptoms, you'd find a lot of people adopting the strangest behaviors
during flu season and you'd say that colds too are as individual as people!

While this variability certainly calls for (and explains the relative
success of) individualized forms of therapy, it is important to try and find
the commonality of what is happening. Even the "argument" between John
and myself, I think, ended in what I perceive as a deep agreement in
how we both have dealt with blocks (i.e. dimistify the individual block
and look at the whole "speaking picture").

Even control vs. non-control is, in my opinion, a non-issue. This is
in part because we don't agree on what we mean by "control". Some people
think of "easy stuttering" as non-control. I think any injection of
consciousness in the mechanics of speech is "control". Again, it is
not surprising to me, given different mind sets and different learned
behaviors, that different stutterers may feel helped by fluency shaping
while others prefer easy stuttering. Still, the common goal is to produce
acceptably fluent speech WITHOUT having to think of the mechanics of it, and
many of us have learned that, in time, this can happen more and more.

I find it interesting that the closer stutterers get to fluency, the
more similar their stuttering "style" gets. Is this so "by definition"
since they are close to fluency?... I don't think so. I think that, as we
throw away much of the learned useless baggage, stuttering becomes quite
uniform. Do any SLPs agree with me on this point?

Friday, March 17, 1995

Objections to "Stuttering University"

In response to the problem of a "separatist enviroment" (problems "re-joining" the fluent world)

I share this concern, and considering that it took me years before
I could comfortably approach other stutteres, I surprised myself in
having changed my thinking. (What follows is part of previous private
posting) The university idea stems from solving the constant dilemma between approaching stuttering by focusing on it and by NOT focusing on it. One could get a degree without attending a single therapy session and yet have "worked" on
one's stuttering by approaching every subject in the context of his/her
path towards whatever degree of fluency s/he sees as a goal. All in
a supportive environment.

Women have used the "supportive environment" argument to justify women's
colleges. I don't know what it is about us stutterers... but even admitting
the need for a supportive environment seems hard to do. Perhaps because
of the 4 to 1 ratio of male to female stutteres there is a pervasive
"malist" attitude that we should be "tough enough" to take on whatever
comes our way. Dare I say that we need larger dosage of good nourishing
"female" thinking?

Response to the "relapse problem" following successful intensive therapy

The idea is precisely to prevent this problem. An "intensive therapy
environment" could not be sustained for 4 or more years. It would have to
become REAL life along the way... good grades, bad grades, your girlfriend
dumps you.. your roommate snores. A recent posting on how John H. and
I agree on this issue should clarify why I think this would work differently,
but I could be wrong, of course.

The more I think about it, though, the more I am becoming convinced that four
or more years where we can FORGET and NOT FORGET about stuttering and
LIVE, with it, without it, though it ... whatever .. could change the
lives of many people.

Response to the need for a better name... ("it's the people who stutter, not the university!")

Before it becomes real, if ever, I am sure we'll figure out a better name,
all the more so since (imagination being so cheap anyhow) I actually envision
some non-stutterers wanting to enroll. Why? The best SLP department, great
engineering, computer science and biology (for control, artificial
intelligence, brain modeling etc.), great liberal arts for personal
growth, international atmosphere, and yes, lots of PWSs... the best
bunch of folks that ever walked the earth (please allow me one of the
few elements of pride allowed to stutterers... you have to become a pretty
special person to survive stuttering with some degree of sanity.. and
most of us do! :-)).

To John Harrison: some points of agreement

Just when I thought that we had parted company and were merrily walking
in different directions I find you again! I agree so much with what you
said in your posting that I had a very hard time selecting just a sentence or
two for reference.

First of all, even though we don't agree on the "nature" of blocks, we
essentially did the same thing: we DIMISTIFIED THEM. You did so by
analyzing what you thought might be underlying psychological causes. I
did so by simply ignoring them, acting as if they hadn't happened and
moving on. Let me add an analogy to all your great ones.

Let's face it, we are lousy windsurfers in the "sea of speech". Fluent
folks seem to be able to navigate no matter how rough the sea gets. As
soon as a few waves show up down we go..

Now, if we really concentrate (focus on "targets" etc.) we can survive
a good wave, but, sure enough, here comes another one... and another
one. It's a lousy way to surf... no fun at all.. and pretty soon down
we go anyhow. Fortunately it turns out that in the "sea of speech"
we can do one very interesting thing: with some effort we can actually
LOWER the waves ("tension"?)! Great! So here comes a wave.. Quick.. remember
your techniques... concentrate.. LOWER the wave! Smack... you hit the
wave... sorry it's too late to do anything about it now... and down you
go. Why can't we lower every damn wave when it comes? Because if we
wait until each particular wave comes it's always TOO LATE.

What's the solution? Forget about each particular wave, look at the
whole sea, look at the sun, enjoy the wind pushing you through the
water. You CAN make the whole seascape calmer, and if you still fall once
in a while it's OK.

I found that when I switched from monitoring each single wave (word) to
monitoring the whole sea the going got a lot easier. Each block was
not an enemy to be conquered so I could go on to the next one (talk
about fatigue!), rather it was a signal, a reminder that a battle had
ensued that I wanted no part of. So I'd back off, wait for the seas/battle
to calm down, and I'd get going again. Eventually I found that I needed
fewer and fewer blocks/signals to remind me to calm the sea, and I found
that the blocks became less severe and often barely perceptible. I also
found that even the tiniest blocks, unnoticed by anyone but me, were still
very good "signals", so I didn't have to wait until major blocks to
remember to lower the waves... I could just keep them down constantly and
ENJOY my speech-surfing excursion.

What are the consequences of this view for therapy? You have just gone
through a two week workshop and you are doing pretty well. Now if you
could just keep doing the same "things" in the real world... right?

WRONG!!!!

You are not at the end of your therapy, YOU ARE AT THE BEGINNING! You have
learned to survive that big wave when it hits you, and that's a great
skill to have, but that's not speech. You have speech, enjoyable speech
(as it should be by definition) when you have learned to create the
conditions that make the sea calmer and calmer and when, in fact, the
techniques you have learned become easier.. and ultimately unnecessary.
It's no wonder to me that so often people simply tire out and "revert" to
the old ways. Techniques are not "solutions" to be harked back to. They
are temporary band-aids to get you on your way. My believe is that future
therapy will, in fact, include the much harder process of "removal" of these
band-aids... I have tried to illustrate here how I have tried to do just
that for myself.

John: I forgot I was "talking" to you... and got on my soap-box. From what
I have read in your postings, it seems to me that you removed your "band-aids"
in much the same way, and I think this is important feedback to both SLPs and
fellow stutterers.

Wednesday, March 15, 1995

Clarification on my stuttering competence

I have been sent private e-mail asking my opinion on various issues and
how they might differ from John Harrison's. With John, I have been very active
on the list lately, and I am very grateful for the opportunity to do so, but
I want to make sure there is no misunderstanding on my level of "authority"
just because my opinions appear frequently...

I am NOT a SLP. I am a scientist, trained in Physics (MA), Biophysics (Ph.D)
and Computer Science. I have been working at NASA for the past 15 years and
I am now doing research in the area of Neuroengineering. I am also a stutterer,
although on a good day you might never guess it. I have had only brief
encounters with therapy and I consider myself mostly "self-taught" in how I
deal with my stutter.

Now to John, me and dealing with blocks. John and I are friends and see
each other occasionally at NSP functions. I have NEVER heard him block or
repeat in any way that would make me think that he had ever stuttered, so
he MUST have done something right. I think my stutter is more easily
revealed but I am also quite satisfied with my own progress. The reason
I am posting this is that many might find it interesting to note that both of us seem to have overcome blocks by coming from different directions. This
certainly accounts, at least in part, for our "philosophical" differences in
this area.

John (I am sure he'll jump in if I misrepresent him) seems to have "studied"
each block as it happened, wondered what was about that particular word
that might have made him want to avoid it, etc. This increased level of
awareness slowly seemed to "melt away" the blocks (correct John?).

I, on the contrary, approached blocking by completely ignoring and quickly
forgetting any word I might block on. I felt (and still do) that blocking,
in its basic essence, was an "accident" that could happen on any word, for
no particular reason, and that, in fact, if I lingered on the word,
wondered why etc., I might add an element of fear to that word, which would
make it more likely that I would block on it again (yes, I recognized a
"psychological" component). I directed my awareness instead to my speech
apparatus as a whole, to decrease any tension in my body and promote
a general sense of well being and joy of speaking no matter what. What I
mean is that I would NOT think something like "oh my God, I've got to
speak... I'd better RELAAAAAX", rather, I would try to make my body
awareness INDEPENDENT of any speaking situation, something I could
cultivate through dance training (I took Ballet, Modern and Jazz training
for 7 years) and classical singing (I know we don't stutter when we sing,
but that wasn't the point). All of these disciplines deal with eliminating
even very subtle tension from your body to free it for the production
of beautiful movement or sound, and to make the whole process as automatic
and subconscious as possible so your mind and body are free to create "art".

I think I slowly learned to tap into that same state "on demand" and use it
to support my speech (and, when needed, the various techniques and "tricks" you learn in therapy). I am not suggesting that everyone should spend ten
years learning dance and classical singing (although it WAS GREAT FUN, and I
met my wife, a beautiful dancer, along the way), but simply that this path is
SLOW, so we might as well try to make it fun, in whatever way suits us best.
Having seen how difficult it is to achieve the subtle control it takes to
become a good dancer or a good singer I have a hard time even conceiving
how anyone can expect that even a few weeks of therapy will "cure" stuttering.
Yes, you can learn tools and tricks that can come quite handy, and can
get you started on your way. But from that point to feeling a true joy
in speaking is a long way... but I really don't mean to sound discouraging,
it can be a FUN way too.

One last thing (apologies for the length of this). I should just mention
that this is precisely the context in which I proposed a "Stuttering
University": a place where stuttering can be "forgotten" and worked on
at the same time... all while having fun... learning... and living.

Wednesday, March 08, 1995

On "blocking"

Continuing a dialog with John Harrison in response that his feeling that blocking is a "strategic response"

Yes, we part company. It feels to me like a bunch of sand has been thrown,
so to speak, onto my speech apparatus. And that causes me to stumble, not
everywhere "at random" but at linguistically significant points, such as
word beginnings. I think not because these words are somehow "loaded" but
simply because they are there. It's as if speaking is like crossing a stream
by hopping on stones. If your legs get weak you end up slipping and stumbling
on some of them.

John feels that there is always an "approach avoidance" conflict present in blocks. He asks "how do I know it's not present"?

That's right, I don't know, and neither do you. I think it's great that,
having both had the dubious "advantage" of feeling stuttering from the
inside, we have concocted different "models". This should give some
reassurance to our friends SLPs who don't stutter!

We agree on so many things that I had lost sight of (or never understood) what
we did not agree on. It really would be boring and perhaps hopeless if we
all marched in lock step. The important thing is we have identified two
possible "models" (if mine can be thus dignified). You attach important
psychological udertones to blocking, I, while not denying that
these could play a role, see "generic" tension as a more direct cause.
Your mental image is "approach avoidance" conscious or unconscious, mine
is "sand in the machinery". I think these different views can have therapeutic
consequences. The next step is to see whether there is any
evidence out there to support one or the other. Do any SLPs and or researchers
on the list have an opinion and/or can cite evidence to shed some light?
(As usual... sorry if all this is old hat..)


Response to a "defender" of Dr. Schwartz's therapy methods

I am really happy that you and many others
have achieved the best results you could have hoped for. This is a credit
to both Dr. Schwartz and to your determination. I can (believe me) feel
the pain you must have gone through in so many false starts and false
hopes, and I understand your desire to share your success with everyone.

Unfortunately a scientific forum like this one must seem quite stubborn
and cold-hearted at time. The very simple fact is that Dr. Schwartz's therapy
has been an equally painful false start for SOME stutterers. I know,
if they had REALLY done it... but this is precisely one of the very
legitimate issues we have been trying to pursue. There is NO SLP I know
who has not had what they would regard as "failures".

So where does that leave us? Many people have come on the list stating
that they had received benefit from Dr. Schwartz's therapy. Nobody had
any negative reactions to their saying so. I personally reacted to your
postings simply because you came across, at least to me, as saying "here
is someone who has THE answer and nobody is paying attention for some
unspecified warped reasons". Well, even aside from my own differences
in thinking, most postings I have seen on this list have found fault
with some aspect of Dr. Schwartz's model, or of his definition of "success".
This is a simple fact I felt obliged to state. Why? Simply because I
think stutterers should be able to make informed decisions.

It is also a fact that many, including me, have paid attention, asked
questions, agreed or not agreed with answers, and conducted what I feel
has been a fair, albeit often inconclusive, debate (I am still ready
to send you what I have collected, if you are interested).

Can I ask you to please help us continue in this fashion? Dr. Schwartz
has been perfectly capable to conduct the debate about his model and
his therapy. Your testimony has been noted. Could you tell us what
hadn't worked in past therapies? What your specific objections are to
other models? I am sure you could come up with more.

There is no conspiracy here. We are all in the same boat. Many of us
have been through a great deal of pain, and all of us are trying to
spare it from others both close to us and far. Let's help each other
do so.

Tuesday, March 07, 1995

Dialog with John Harrrison

Thank you for taking the time to point out and address in detail many
crucial statements made by Dr. Schwartz in his book. This has been a
great service to us all whether or not they will be "dismissed" by the
author. I agree with you in the general thrust of your arguments, and they
bring to mind a couple of points I would like to make.

It is clear to me that progress in stuttering recovery is greatly enhanced
by (or even requires) bringing together the best of our mental capabilities or,
as you aptly put it "getting our s**t together", but this is NOT because
stutterers are inherently less together than the rest of the population
(one just needs to attend a few NSP meetings to convince oneself of this
fact), but simply because the beast is hard to tame and we must gather
all the strength we can get, wherever it is. For most people speech is
a nice stroll in the woods, for us it is mountain climb. Strollers can
get by with average fitness, we need to be athletes, mental athletes.
I pointed this out in the context of another post, but it's worth repeating.

The other point, where perhaps we don't agree, but it's worth a discussion,
is your concept of blocking, essentially Sheehan's approach avoidance. My
past experience of blocking might fit, in the sense that I remember fearing
certain words and sure enough... I would block. But relatively soon, I realized
that fear or no fear, if I monitored my general level of tension and eased
into the words, they would come out fine. In time this of course decreased the
fear and made the whole thing easier, essentially reversing the cycle. But
here comes the clincher, occasionally I still block, but is seems to be right
out of the blue, no fear of words or situations, it's just like russian
roulette. What is still true is that, if I monitor (and lower) the degree
of tension of my whole speech apparatus these "surprises" occur very rarely.

So here is what I think. For reasons yet unknown our speech apparatus
(yes the WHOLE system as you would say) is particulalrly vulnerable to
tension and there are several areas in which it can "break down". One of these
is the articulation at the beginning of words (here is where the
SYSTEM comes in, including the cognitive levels where the idea of "word"
is formed, as opposed to low level causes such as "spasms"). Yet, while
approach avoidance increases tension, it is GENERIC tension that cause
(by yet unknown mechanisms) blocks, NOT the specific tension surrounding
avoidance of a particular word. This still implies that approach
avoidance behavior is very likely to be associated with blocks, but it
allows for a situation, like mine, where the absence of this behavior still
does not guarantee the complete absence of blocks.

In summary, approach-avoidance -> tension -> blocks. When approach-avoidance
is the overwhelmimg source of tension then it looks like a direct path
approach-avoidance -> blocks. BUT, even when there is no approach avoidance,
you can still have tension (from other sources) -> blocks.

Does this make any sense to you or others? Are there therapeutic
consequences to this view?

While I am on the subject of blocks, I have always felt uncomfortable with
notions of "airflow blockage" as implied by the Valsalva maneuver analogy.
I have certainly seen people exert a lot of effort to get a word out, including
face contortions that might remind one of suffocation (I learned to "give up"
at the first hint of effort), but It seems to me
that many blocks are actually accompanied by a lot of sound and flowing
air. The cords are vibrating, air is coming out, what is blocked, it seems
to me, is the ARTICULATORY process, i.e the MENTAL process of moving on to
the next sound. It is as if a pianist tried to play a melody and only managed
to play the first note, the pianist then tries again, and, again, only the first
note comes out. They keys are fine, it's the hand that can't continue. It's
this mental "hand" that gets stuck, the next nerve impulse that's supposed
to come down the pipe, but won't. Can others confirm this observation
or am I dreaming? I hear blocking on vowels and sounded consonants I can
recognize... so air and sound are coming out! Why can't we go on to the NEXT
sound? That, to me, is the key.

Monday, February 27, 1995

An institute?

In response to a comment about an institute

Well, for one thing an institute can be a stepping stone towards a
University, and perhaps the only realistic approach. BTF (and I
have been reading about it only very quickly) might well be an
excellent example.

Fortunately imagination is cheap though... The university idea stems
>From solving the constant dilemma between approaching stuttering
by focusing on it and by NOT focusing on it. One could get a degree
without attending a single therapy session and yet have "worked" on
one's stuttering by approaching every subject in the context of his/her
path towards whatever degree of fluency s/he sees as a goal. All in
a supportive environment.

Women have used the "supportive environment" argument to justify women's
colleges. I don't know what it is about us stutterers... but even admitting
the need for a supportive environment seems hard to do. Perhaps because
of the 4 to 1 ratio of male to female stutteres there is a pervasive
"malist" attitude that we should be "tough enough" to take on whatever
comes our way. Dare I say that we need larger dosage of good nourishing
"female" thinking?

The more I think about it, the more I am becoming convinced that four
or more years where we can FORGET and NOT FORGET about stuttering and
LIVE, with it, without it, though it ... whatever .. could change the
lives of many people.

Thursday, February 23, 1995

Stuttering University

These broadened therapy concepts remind me of an idea I have toyed with
on and off for some time: a Stuttering University! The model might be
something like the university for the deaf (sorry, the name escapes me
for the moment) but the idea would be more than creating a "safe"
environment for learning. The idea is a place where, in the context of
getting a degree, a student can approach stuttering from all possible
angles.

It would also be a place where research, both therapeutic and basic, could
thrive.

Some examples: I feel that one of the best things I have done for my
stuttering has been to study dance for several years! I wasn't sure it would
help, but I had a gut feeling that increasing the general awareness of my
body and areas of tension would help me achieve a "natural" kind of
control.Take it for what it's worth, but I think it really helped. Anyhow,
thisis only an example of how learning (and having fun!) in different areas,
including art, drama (I've done that too... equally useful!) can be brought
tobear to tame this beast.

In the context of research, this could be a major center for brain studies,
brain disfunction, artificial neural networks (my area!), psychology...
the sky is the limit! We could also have a media center to produce
materials for schools and networks. There could be a school of engineering
focused on control theory, systems, artificial speech, electronic aid
devices, computer science.

SU (Stuttering University.... I know, we can come up with a better name)
would be international... and I would love to see it located in the
S. Francisco bay area (where I live... of course). It would also have
a strong Internet-based component, to allow some level of attendan(virtual
attendance) for people who couldn't manage to move here for the required
time.

How about it? Could we do it?

Wednesday, January 25, 1995

Model-1

To M. Schwartz

> We have gone around in one big loop. In an earlier message you
> described three apparently seperate "theories" of stuttering (organic
> based, tension based and learning based), then made the following statement:
>
> > > "So, as you can see, all three theories are correct and all have their
> > > appropriate place in the model"
> > >
>
> To this I replied the following
> >
> >
> > Indeed I think all three "theories" are "correct" i.e. they cover
> > likely important aspects of the stuttering phenomenon, but I fail
> > to see how your model is a particularly parsimonious way to account
> > for them.
> >
> > An organic weakness can easily make someone more vulnerable to
> > tension (some people blush instead of stuttering - my palms sweat...AND
> > I (used to) stutter under tension). In addition, when faced with
> > difficulties, we learn behaviors that seem to help us overcome them.
> > Sometimes these behaviors end up being worse than the problem. Persons
> > who blush may cover their faces with their hands, which may end up
> > being more noticeable than the blushing...
> >
> > In this context one can have therapies that work at decreasing tension,
> > unlearning unproductive behaviors and/or learning good ones, and, if
> > a good drug is found, the "root" organic problem might be addressed
> > as well (too much or too little seratonen...or what have you).
> >
>
>
This simple explanation of how these ideas can easily be combined in
> providing a rough accounting of stuttering behavior is what I called
> "model 1" ... just as a reference point. I make no claims of having
> created or proposed a model that is "mine". Model-1, it seems to
> me, (please SLPs correct me if I am wrong) underlies most therapeutic
> efforts in stuttering.
>
> My question to you was and is very simple: are there stuttering behaviours
> which can be accounted for ONLY by your model and not by this
> reference model (Model-1)? I really would like to understand.
>

Monday, January 23, 1995

Stuttering "cures"

This is a response to a post where M. Schwartz compares his stuttering therapy to an "antibiotic" that could cure everyone... as long as they agree to take it...

The "bacterial infection cure" analogy is a perfect example of the
kind of complete misunderstanding of the stuttering phenomenon that
has plagued relationships between PWS and SLP. I am sorry for
letting go of my customary scientific circumspection. This is a
stutterer speaking now, and one who is very grateful for the kind of
care and real understanding that is being dispalyed by most SLPs on this
list.

You put me in a room, ask me to focus on fluency for a reasonable
period of time and you won't be able to tell me apart from any
other fluent speaker. I have learned to control my speech so that
I don't stutter if I put my mind to it. Am I cured? Can I then set
forth and "Stutter no more"? In analogy with the Cristian Scientist,
am I making a CHOICE not to use the speech "tools" I acquired because
I believe that God willed it that I be a stutterer? Do I have some
perverse psychological reason for refusing to use the tools that
would liberate my speech for good?

The answer is NO to all of the above. The simple fact is that
the controls that enable me not to stutter require a constant mental
effort that fluent speakers do not have to exert. The problem
is not that I am unable to exert control or that I am unsuccessful
at it, the problem is that I HAVE to. THAT is the problem. Therapy
that focuses on providing these control techniques is certainly
welcome for those who need it, and many do, in order to do the
many things we have to do to survive, but please don't call it
a cure! The problem is still there even if we can momentarily
get around it.

People leave therapy programs because they either have difficulty
accomplishing these speech "control" tasks, or because they
realize this is not what they thought a "cure" would be. In some cases
they even feel that exerting speech controls is far more cumbersome
than stuttering.

This is the reality of the stuttering phenomenon, and this aspect needs
to be accounted for by any "model" of stuttering just as much as
all other obvious external manifestations.

It is also the case that speech controls can become less cumbersome
and more "subconscious" with time (my experience). Perhaps new
neural "remedial" pathways are formed, just like learning a new
language. This "model" however does not account for "sudden cures".
So, there are four possibilities: they are not really "sudden",
they are not really "cures", the phenomenon was not really
"stuttering" or the model is wrong.

The law of parsimony

> Dr. Schwartz:
>
> This is getting a bit tangled, but let me try anyhow.
>
> You started by presenting three "separate" theories of stuttering and
> went on to state that your model nicely accounts for all of them (the
> ONLY model that does so, you further added in your reply).
>
> I stated that the three "theories" seem quite compatible to me and that
> they already formed what could be viewed as a reasonable "model"(let's
> call it Model-1 for future reference) . I asked therefore what your
> model added to this "simpler" (i.e. more parsimonious) model.
>
> You stated in your response that your model is "extremely parsimonious",
> further more, if there is any complexity I don't understand you'd be
> happy to explain it to me.
>
> OK. now I can clarify my point:
>
> "Parsimony" means to explain all the facts with the least amount
> of assumptions. You make some clear assumptions about the role
> of vocal cords (thank you for your misspelling correction - caught me
> red faced on that one). What additional explanation do these
> assumptions provide, which Model-1 could not explain as well?
>
> There are two good reasons for adding complexity to models: explaining
> more facts and providing for the possibility of testing (which still
> is a form of "more facts"). I still don't see which facts your model
> explains which are nor explained by model-1. With regard to testing,
> I praised your model, in that it opens up the possibility of discussing,
> indeed testing, the role of vocal cords in stuttering. But here again,
> you seem very quick in dismissing evidence that might challenge your
> assumptions. You claim that repetitions in sign language do not obey
> "rules" of stuttering and considering them is "misleading and confusing".
> What rules are you referring to? It would in fact be very interesting
> to see how different this type of stuttering is and whether any
> differences are a rather obvious result of the differences in communication
> channels or hide something deeper. Also, could you provide a couple
> of examples of how, in your thinking, the laryngectomy papers you have
> had the time to survey tend to support your model?
>
> By the way, I do not equate "complex" with "unclear". As a Ph.D. in
> Biophysics and NASA researcher for 15 years in areas from
> closed ecologial life support to artificial neural networks, complex
> models and scientific methodology are my daily bread.
>
> Let's keep trying.

Thursday, January 12, 1995

Three aspects of stuttering

To Martin Schwartz (about three aspects of his model)

> Indeed I think all three "theories" are "correct" i.e. they cover
> likely important aspects of the stuttering phenomenon, but I fail
> to see how your model is a particularly parsimonious way to account
> for them.

Schwartz answers that only his model integrates all three aspectw in a comprehensive way. As such he believes it is parsimonious.

>
> An organic weakness can easily make someone more vulnerable to
> tension (some people blush instead of stuttering - my palms sweat...AND
> I (used to) stutter under tension). In addition, when faced with
> difficulties, we learn behaviors that seem to help us overcome them.
> Sometimes these behaviors end up being worse than the problem. Persons
> who blush may cover their faces with their hands, which may end up
> being more noticeable than the blushing...

Schwartz agrees that there is an organic weakness

>
> In this context one can have therapies that work at decreasing tension,
> unlearning uproductive behaviors and/or learning good ones, and, if
> a good drug is found, the "root" organic problem might be addressed
> as well (too much or too little seratonen...or what have you).
>

Schwartz agrees

> What additional explanation justifies the extra complexity of your
> model? I do see one advantage in the detailed cause-effects you
> have spelled out - as I understand them - and that is that there
> are instances where the model can be seen to fail. The model I
> very simply expressed is NOT very useful in the sense that it is hard
> to figure out a test case where it would fail. Again, a good model
> is one for which one can at least think of a situation where, if the
> situation applies, the model fails. If a particular model can never
> fail it's not particularly useful, and this includes the one I
> expressed.

Schwartz denies that his model is "complex" and doesn't understand my second point
(if there is no situation for which the model can fail, then it's not a good model - This is a fundamental concept in science)
>
> Now, your model IS useful in postulating the dominant causative role
> of vocal chords, because now we can test it! If the vocal chords are
> not involved stuttering shouldn't happen. Evidence has been cited, such
> as stuttering behavior in sign language... and you have dismissed it
> as irrelevant to the problem. I am still scratching my head trying to
> figure out how you can possibly consider it irrelevant. How could
> it be more central? Also, have you had a chance to look at the other
> evidence involving vocal chords (I don't recall whether it dealt
> with surgery or paralysis, but it was cited by Woody and you said
> you wanted to find out more about the extent etc.)?

Schwartz doesn't consider stuttering in sign language "stuttering", so point is irrelevant to him. He also claims that the laryngectomy literature supports his model.

>
> While I am stirring the pot, let me bring up one situation that
> is not explained even by the weak model I presented. You mentioned it
> in a response to the list: that of "sudden" and "complete" cures.
> I encountered one person who claimed to have awakened one day with
> not a trace of his previous stuttering. I also know of people who
> claim to have had out-of-body experiences. Are we here in the realm
> of parapsychology or have serious studies been done of such cases?
>
> I can see how "complete" cure can be a matter of perception. I could
> start saying that about myself and probably nobody would argue, but
> "sudden"? As if someone could shake a loose wire in the brain and
> re-establish a missing contact? Any ideas?
>
Schwartz says that he will relate his experience on people who "stopped" stuttering later on.