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Book review: “Speech is a River”

September 26, 2011 By Leave a Comment

“She’s got it, by George, she’s got it!!!” That’s what I said over and over again as I read Speech is a River: My Recovery From Stuttering, by Ruth Mead. This book explains so much about the inner game of speaking from the viewpoint of a person who stuttered and who no longer stutters. With clarity, wit, humor, and a not a small measure of political incorrectness, Mead takes on many of the false beliefs that perpetuate and exacerbate stuttering.

Ruth Mead is a writer. I don’t know if she is a professional writer, but she is a personable writer who opens a window into the mind that is behind the stuttering. In Speech is a River she describes her own mind, thoughts and observations, but I don’t think there are many people who stutter who will read this book and not recognize something of their own mind, beliefs, reactions, perceptions and behaviors.

The main premise throughout the book is that people who stutter let their conscious mind try to control the natural spontaneous speech that can flow within. She talks about her own discovery that “Speech is not amenable to coercion”, and explains how she stopped trying to plan and think about how to say words or push air through the block she felt in her throat..

Mead is no stranger to speech therapy. She discusses her experiences with some of the therapy approaches that she is familiar with. She then goes on to explain her recovery through a self-help journey that changed not just her speech; it changed her state of being.

As much as I agree whole-heartedly with everything that Ruth Mead says, I have to add, from the perspective of a clinician who sees many people who stutter, there is more to the “journey” than changing one’s worldview of speaking. There are brain processes that come into play that might intensify the mind’s attempt to control speech. Nevertheless, no therapy will be beneficial when the conscious mind is trying to get out words or say them consciously. That is why this book is so important. It really is the only book that I know of that discusses in length the debilitating tendency to plan, rehearse, think about and try to say words.

As a person who is determined to understand stuttering and guide people to overcome it, I am personally grateful to Ruth Mead for sharing her experiences and making her book available as a free download http://stutterers-anonymous.com/.  This is a book that every person who stutters and their families and friends would benefit greatly from reading.

Filed Under: nature of stuttering, therapy approach, treatment results

The Key To A Successful Treatment Experience

April 7, 2011 By Leave a Comment

Do you want to speak with ease and confidence? If you do, read on. You are about to find out how every one of my successful clients has accomplished this. If you learn from this, you will better understand what you need to do to create the automatic and natural way of speaking that you desire.

Successful clients understand that once they learn the new process, they have to repeatedly use it with awareness. They know they are not going to become normally fluent speakers overnight. Speaking in a different way is not something that will instantaneously happen, they make it happen.

In addition, they know that thoughts and actions together determine the habits that they develop. Clients succeed because of the thoughts and the actions that they take. During Stuttering Online Therapy clients are encouraged to think beyond their habitual thoughts. Successful clients are able to give up their fears as they realize that the feeling of fear is related to thoughts connected to the past. They replace old thoughts with new thoughts of joy, ease and comfort that are part of their new way of speaking.

These are three of the basic ingredients to a rewarding therapy experience.

1. The first is to have a clear intent. Focus on your intent i.e. have a clear goal of what you want. You will learn that the energy for speaking comes from the signal that your brain sends to the vocal folds as you focus on the general message that you want your listeners to hear. You will learn that your voice, not words, is the essence of talking. Make your intent the discovery of how to make your own natural voice be heard in a way that is new to you. Dynamic Stuttering Therapy is a goal-oriented therapy that shows you how to produce speech naturally. If your intent is to achieve the goals, you will find that they will become a part of you. If you intend to change, you will make the change.

2. The second ingredient to success is to be proactive. Thinking about what you should do, or knowing what thoughts would be nice to think will not help at all. You have to be the one to take action and make things happen. If you are not doing anything, you will produce nothing. The brain makes new connections through repeated experience doing the same thing. That is why repetitive practice is more important once the goals of therapy have been achieved than it is during the learning stage. Repetition of the process and making sure you do something each day to strengthen the process and create new thoughts is absolutely necessary for long-term success. Action produces results.

3. The final ingredient is to never give up. This is common sense, but unfortunately, too often people give up at the first barrier they encounter when working to achieve their goals. There are even people who go to therapy expecting failure. From the very beginning every mistake, every problem is reinforcement to their existing belief. Successful clients do not focus on and reinforce problems. Instead, they take note of every small change, and attend to how different and pleasant it feels every time they experience giving up the control of how to get words out words. They decide that they can change what they think and what they do and they do not quit until they reach their goals. They know that quitting is a waste of all the effort that was previously exerted. Successful clients see errors and setbacks as opportunities to learn that lead to improved knowledge and ability.

Some people look at how fluently successful clients are speaking and ask me what technique was used. The answer I give is that they became aware of what they needed to change, had the clear intent to change their mind and process and took the initiative to do so.

 

 

 

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Taking Stuttering Therapy Beyond the Clinic Setting – All About Transfer

February 16, 2011 By Leave a Comment

People who stutter often say that they are able to speak fluently in the clinic, but find that their fluency disappears when they leave. This is a serious problem and I believe the solution lies in rethinking the issue of “transfer.”

One problem in “transfer” is, of course, that people want to transfer fluency. Anyone who has been following my blog knows that I don’t believe that fluency comes and goes by itself.  It is how the person’s brain functions that results in either stuttering or fluent speech. So if you are trying to be fluent and disregarding process, the results will be very disappointing.

Another problem is that people jump too quickly from being able to process speech in a way that results in fluent speech to wanting to use this way of speaking all the time. When I was a young and inexperienced clinician, I used to be happy when clients would say, “This is a wonderful way of speaking, I’m going to speak this way from now on”. Today, I realize that this is unrealistic. It takes time for the brain to accept a new way of functioning. This acceptance happens only after a period repetitive focused intention that enables the network of neurons in the brain that is now firing together to become wired together. When this happens the way of speaking becomes part of the self.

My advice to clients who have learned to process speech normally during our sessions is not to expect that because you know what to do it will happen automatically. Also, I do not want them to go and try to use this process when they are feeling anxiety and trepidation. Instead of going off into life and “trying” to speak this way, I encourage them to use the process alone and in non-threatening situations again and again and again. I want them to use this process of speaking for their own fun and enjoyment. I want them to see the relationship between process and results and I want them to get the sense of how peasant and easy it is to speak this way. As a matter of fact, I tell them not to even think of using it in any situation until they can’t wait to start using it, until it feels like the preferred thing to do. When that happens they will not be trying to do something they fear they cannot do. They will be confidently doing something they love to do. Under this circumstance, transfer will not be a threat it will be a pleasure.

Filed Under: dynamic stuttering therapy, fluent speech, speech control, therapy approach, treatment results

Whose fault is it?

August 22, 2010 By 2 Comments

Have you been through a therapy program hoping to improve your speech fluency and in the end didn’t see much change? If you have, you are not alone. This is too often the case, even after years of treatment. Why? Who is at fault? Is it you, the client? Is it the clinician? Is it that fluency in real life is not possible? Or is the treatment approach that is not adequate? In my next few blogs I will discuss where I think the fault lies from the all these angels.

Before I begin, however, I want to say that looking for the responsible source i.e. “fault” is not the same as placing blame. There is a big difference between where the responsibility lies and the need for blame or guilt. For instance, once most people died from pneumonia. Was the doctor or patient guilty? No. Was the treatment at fault? Yes, and the reason was the lack of knowledge about bacteria and how to kill it. Therefore, at that time we could not blame or place guilt on the part of the people involved. Today, we have the knowledge of how to treat most cases of pneumonia, so a doctor could be blamed for not recognizing the signs of pneumonia (as my doctor failed to do 3 years ago when I had it); a patient could be blamed for not going to a doctor when feeling sick, or not demanding better tests and treatment when the condition is not improving (as I did when I wasn’t getting better), or not taking the medicine that was prescribed. Nevertheless, I would prefer to search for source, because blame and guilt are not constructive in a search for solutions.

So let’s get back to stuttering. If we are going to look for whose fault it is that so many people do not achieve the long-term ability to speak fluently, I think that the first place to look is the treatment approaches being used. Simply stated, I believe that the major cause for the failure of treatment is a lack of knowledge of how to treat it. Most treatment approaches focus on fluency or try to modify the moment of stuttering. However, it is obvious to anyone who has tried it that you don’t become a fluent speaker by treating the stuttered speech and trying to make your speech non-stuttered.

Speaking is a neurological activity in the brain of a person who has thoughts, feelings, intentions, genetic tendencies and memories. We have seen through various types of brain scans that the brain works differently in people who stutter. Therefore, changes in the brain need to be made in order to create fluent speech.

Not only is speaking is an activity of the brain but for the most part it is an unconscious activity. People are not meant to think about how to speak; how to get words out; which words should be said. People are not meant to preplan their speech before speaking. Why then should stuttering therapy train people to monitor and control how they breathe, how to hold or relax the muscles of the mouth, how to say sounds more gently and smoothly, how to change the way you stutter? Stuttering represents control of a system that is meant to function subconsciously, so why ask people who stutter to develop speech controls and “tools”? Tools and controls are not part of normally fluent speech.

Managing stuttering by way of speech controls has been the long-standing method of choice. It’s time to try a different approach, one that has eluded too many clinicians and clients for too long. We have to keep our minds open to a new perspective that incorporates research findings and clinical observations. This is the 21st century. Strides are being made in the understanding and treatment of human conditions that only a short time ago were not understood or treatable. The old paradigms that have been the driving force of stuttering treatment until now do not fall in line with current research and do not explain all that is known about the nature of stuttering. Until stuttering therapy helps people use their brain the way it is meant to function in order to produce speech, the ability to produce normally fluent speech will continue to elude clients and clinicians alike. Change is a reality of life. Now is the time to rid ourselves of the concepts that have not lead people who stutter in the direction that will give them a successful treatment experience. Now is the time for developing a treatment approach that will lead clients to speak with ease and freedom from control.

Filed Under: controversy, dynamic stuttering therapy, fluent speech, therapy approach, treatment results

Acceptance or Speech Techniques

August 1, 2010 By Leave a Comment

At the recent National Stuttering Association convention, there were many conversations revolving around the conflict that people who stutter often experience. It is whether to use “speech tools” or accept oneself as a person who will always stutter. When I hear people struggling to decide which path to follow, I so want to tell them that there is an entirely different way, a way of self-acceptance and the ability to speak with easy and natural fluency.

The speech tools and techniques that people falsely believe are their only hope for improving fluency fall under the classification of fluency shaping techniques and ways of modifying stuttering. At best, some of these techniques may reduce the incidence of stuttering at times to some degree. However, even when this happens, most do not lead directly to normal brain function for the production of speech. They require effort, thinking about how to say words, speaking at a measured rate or remembering to stutter purposefully in conversations, just to name a few. It is no wonder that many people who stutter tire of using these artificial techniques in order to control their speech, that they may not realize is already being produced with too much control.

The brain is meant to produce speech automatically, while we concentrate on the ideas that we want to communicate to the listener. Controlling words and trying to get them out interferes with automatically producing speech and leads to the feeling of being out of control as you stutter without being able to prevent it. Using speech tools in addition further reduces the automatic production of speech. Even if stuttering is reduced, the brain is not functioning naturally.

Some people who stutter are so used to using an ineffective neural (brain) network for speaking that they use it even when not consciously controlling their speech. They can learn and experience the neural network that is aligned to the principles of normal speech production. It requires attention, a different intent and repetitive activity. The result is normally fluent speech.

There are options for people who stutter. One option is to accept stuttering and to live a full life as a person who stutters. Another option is to stutter internally with or without stuttered speech as you use tools and techniques not used by normally fluent speakers. The third option is to change the way your brain functions when speaking so that you are speaking normally, naturally, and without effort or control. This change is possible, because it is now known is that even adult brains can change in function and even in structure.

Filed Under: controversy, dynamic stuttering therapy, Emmotions, fluent speech, therapy approach, treatment results

Ariel’s story – a client before and after stuttering therapy

May 31, 2010 By 1 Comment

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Shmulik’s story – stuttering “no longer an issue”

May 31, 2010 By 1 Comment

11 years after treatment with Stuttering Online Therapy, Shmulik, who once stuttered severely, explains that stuttering is no longer an issue in his life.

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Gil’s story – before and after stuttering therapy with a client

May 31, 2010 By 1 Comment

At Stuttering Online Therapy, we see firsthand the progress our clients make, but we love it when our clients are happy to speak for themselves.

During Gil’s first therapy session:

Gil: Let’s say, there are times when I realize that my stuttering slightly bothers me. It happens when I’m a bit tired or if I go out to a pub and drink. Then my thoughts are not organized; they are free and not in my control. I noticed at these times that I have a tendency to stutter more. Or I have problems with the flow of speech, so in these situations I have more stuttering…

After 15 hours of treatment:

Gil: First, I got a new way of expressing myself. (Before) the words were always in my head, but the way to get them out was a bit of a problem.  (Now) the ideas simply flow in a very free way.  Suddenly, after a long time of not doing this and not being used to doing it, you feel a real relief. Suddenly everything goes smoothly like it’s supposed to. Speech is something so basic. It’s your way of communicating with the outside world. Suddenly, something that was so difficult and not right goes smoothly and, in short, that gives you an excellent feeling.

(In this therapy), you have goals that are A,B,C,D and you know you have to focus on them. These are the basics and you go according to them. This makes the therapy very focused.  It doesn’t say to you, “Well, you have to loose 50 kilo in a half a year.” It’s not like that. It’s not something abstract like that. There are specific goals that go with you all the way. The therapy is very focused.

Barbara: Have you changed your perspective about what speech is?

Gil: Yes, of course. Before (treatment) I didn’t know at all what it was – how you develop ideas, how it gets out of your mouth, how everything happens in your brain. Suddenly you actually realize that it (speaking) is really about not doing anything.

Barbara: What is your feeling today as you complete the formal stage of therapy?

Gil: Humm. First there is still more to do. I am not yet 100% there, so that I can’t say, “Great, after 15 hours of this treatment course, I can do everything that I want.”  But first of all, it really contributed a lot to my self-confidence. If once, you were afraid or hesitant to open your mouth because of how people might react or because you couldn’t speak fluently, then it’s already normal not to be that way. That helps a lot. I don’t know, it’s just that everything is so much freer. The thoughts that you always had that were such a bother are reduced. They suddenly just aren’t there. So you have the time, freedom and energy to think about a million and one other things. Once the energy was directed to another place. Now you have the energy to use freely for whatever you want. You have peace of mind.

The therapy on skype is something that I had heard of for the first time and had never thought of doing it. I had never heard of such an option. At the beginning I was a bit skeptical.  I said, “What? Via skype?” I am used to using skype just to talk to my friends abroad. It seemed strange to get therapy via skype. But, honestly, it is a great development. It’s not the conventional way of coming (to a clinic). It cuts out a lot of the bureaucracy of traveling, parking and sitting face to face. The therapy was much more comfortable and pleasant.  It’s so much nicer. You go home to your own home and open up your computer for a 1-2 hour session, and that’s it. You’re finished. You also have all your home practice on your computer. It’s not the regular therapy and I really liked it a lot.

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Relapse After Stuttering Therapy

May 20, 2010 By Leave a Comment

A common complaint of people who have undergone stuttering treatment is that the results don’t last. This complaint relates to many other conditions, such as weight loss, anger management, addictions and so forth, and is discussed in a wonderful book, Changing For Good, by Prochaska, Norcross, & Diclemente. The authors discuss the reasons that people who come to treatment wanting to achieve certain goals do not maintain their accomplishments, and they outline a program to overcome this problem. I believe it is a must read for people who want to help themselves to make long-term changes in their behaviors and attitudes. In fact, I have incorporated the principles of this program in the Dynamic Stuttering Therapy Workbook.

Over and above the general difficulties of maintaining change, stuttering is a condition that presents special difficulties for the maintenance of change. One of these is that there is most likely an innate tendency for the brain to use an ineffective way for processing speech. Another is that most people who stutter are usually trying to change the wrong thing. I would like to address these two issues.

Research has shown that there are functional and possibly structural difference in the brains of fluent speakers and people who stutter when speaking. These findings are overlooked in most treatment programs. When working on speech tools, the goal is usually to change speech without any consideration of how the speech is being produced. Tools include smooth, slow speech, gentle onsets, pullouts, cancellations and voluntary stuttering. Working on using these techniques is like trying to change how the cake looks when it is finished instead of changing the ingredients and how they are put together. They deal with the result of speaking, the speech, instead of working on how to make it.

In Dynamic Stuttering Therapy we relate to the neuro-physiological process of speaking. During therapy one of the biggest challenges is to get clients to report on how they process speech both in practice and conversations between therapy sessions, instead of on whether or not they stuttered. I find that the clients who succeed in making this switch in perspective are the ones who maintain the new process and enhance their ability to speak fluently. This makes sense. If you are trying to be fluent, who knows what you are doing. It’s all a matter of chance. If you have a way of making speech that results in natural fluency, as happens when you use the processes you have used during therapy, you can make certain you use it.

Once we accept that there is a correct and incorrect process for making speech, there is still a need to cope with the innate tendency of the brain to function the way it is used to functioning. We have a clearly defined process for producing fluent speech, but that does not mean that just because you know the process and have used it, the brain will always function this way. People who stutter have to decide to use the process. The process doesn’t happen to them. They make it happen. Brain processes become stable only when they are repeated over and over again with awareness for at least 6 months to a year. This requires carrying out the process with awareness for a long time after knowing what and how to do it.

When the goal of therapy is to process speech normally, the issue of regression changes. Stuttering doesn’t come and go. You do not have to hope that you will maintain results.  There is a direct connection between what you do and the fluency of speech. Regression does not happen, although the speaker might not use the effective process all the time. In this case stuttering may occur. Nevertheless, if you know the processes for producing fluent speech, you know how to return to it. Being able to do this is not a matter of chance. It is an empowering experience.

Filed Under: fluent speech, nature of stuttering, therapy approach, treatment results Tagged With: , , , , , , ,

Leading to Recovery From Stuttering

March 31, 2010 By 1 Comment

My experience in treating a few thousand people who stutter has shown me that while it may not always be easy, it is possible for most people who stutter to develop the ability to produce normally fluent speech. We do not yet understand why some people do use different neurophysiologic processes for producing speech, but we see so many examples of people who have apparently changed these processes. These are the people who once stuttered and no longer feel the same difficulty when speaking.

There are a few examples of famous people who for the most part have become fluent speakers. Carly Simon, who once struggled with stuttering, set her speech to a rhythm. In an interview she gave with Tavis Smiley, she showed an example of how she made herself speak with what she describes as syncopation. To me it looked like her speech progressed in syllables, as she was no longer trying to get words out. In the same interview, Smiley, who also once stuttered, says he began speaking fluently by imitating the cadence of Dr. Martin Luther King’s speech. This is an example of achieving a normal pattern of intonation.

Vice President Joe Biden tells of his efforts to overcome stuttering by practicing reading aloud in front of a mirror and trying to eliminate the contortions of his face.

My clients changed their neurophysiologic processes by learning to develop speech internally without any effort to get it out and by letting their voice reflect normal patterns of intonation while giving up all control over forming words or speech sounds.

Whether the change was made by self-help or within a treatment program, we can learn a few things from people who as older children and adults do change how they speak I am listing a few of them here:

  1. They investigate how people who do not stutter speak.
  2. They learn from watching and listening to themselves when they speak.
  3. They become aware of the act of speaking, instead of trying not to stutter.
  4. They are persistent in looking for solutions, instead of focusing on problems.
  5. Whether or not it is their conscious goal, they change the intonation pattern of their speech.
  6. They take responsibility for the recovery process.
  7. They are willing to do repetitive practice on a daily basis.
  8. They believe they are capable of making changes.
  9. They focus more on what they do rather than blaming external situations for their stuttering.
  10. They realize making change requires patience and time.

If you want to help yourself to speak with greater fluency, the first step is to develop as many of these qualities and behaviors as you can. It will make the process of change easier and so much more rewarding.

Filed Under: clients, dynamic stuttering therapy, fluent speech, general information, therapy approach, treatment results Tagged With: , , , , , ,
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