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.