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.

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