The ISAD online Conference is in full swing now. There are many interesting papers to read there. I hope all of you will log in and read those that papers interest you. This year I am on the “Ask the expert” panel. The following is one of the questions on the site, along with my answer.
Q: Hello, I read the article Reducing Negative Emotions and Anxiety Using a Mental Approach on the ISAD website and was left with some questions. In therapy, would you devote an equal amount of time in therapy to mitigate negative emotions and anxiety as you would to working on fluency? Furthermore, which method do you think is the most efficient for teens?
A: Stuttering has many facets. The research points to the main cause as being a malfunctioning speech production system. This means that the brain is not producing speech in a way that results in normal fluency. The brain, however, is not only responsible for motor function and language formulation; it also holds our thoughts and produces the neurotransmitters which cause our feelings. The interaction of the whole system is such that I can’t see how we can treat only the thoughts and feelings or only the neuro-motor processing. I think all this has to be treated as part of an interacting system.
Time-wise, it’s hard to say if we need to devote more or less time to one aspect or the other.
I believe that we need to relate to both aspects simultaneously. That means, for instance, neurologically the person who stutters might be learning to produce a natural voice for speaking. While doing this there are thoughts going through the person’s mind. These thoughts need to be recognized and identified as either helping or inhibiting progress.
Thoughts can be changed when necessary. Sometimes, clients begin speaking with natural fluency, but their thoughts are the same as they were previously and the person believes that it will be difficult to speak that way in certain situations. That belief will send messages to the speech production to go back to its old behavior. On the other hand, if we only try to help the person get over the fear of blocking without giving him an easier way to speak, it seems that we are trying to get the fireman not fear fire without giving him any way to avoid getting burned.
When clients change the way of speaking without changing the thinking processes involved, or try to change the thinking processes without making speaking flow more easily, the result is conflict and frustration.
You asked about teens specifically. That is an age when so much is changing. Thoughts and feelings are constantly fluctuating and the brain is still developing the ability to speak. I think the dynamics of nature at work here can be used to our advantage. If we help the teen to be aware of his thoughts and feelings and how he is using his brain and speech musculature to produce speech, we can help the whole system evolve into a freer, more comfortable system.