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.

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