Stuttering Online Therapy

Desire of people who stutter: Becoming fluent

Reason for continuing to stutter: Trying to become fluent

So many people who stutter go to therapy to fulfill their desire to become a fluent speaker, only to be disappointed when it doesn’t happen. They try and they try, and the more they try, the more they become frustrated. The consequence is either giving up on their hope of ever speaking without stuttering or continuing to search in vain for the magic cure that will get rid of their stuttering.

I don’t believe there are any magic cures, but I do know that people who stutter can speak fluently. I also know that people who stutter will never speak with normal fluency by trying to speak fluently. As a matter of fact, trying to be fluent is very counterproductive, because it usually makes the person more aware of words (a good way to make stuttering happen), and putting in more effort to try to get them out (adding control to what must be an automatic process).

It’s hard for people who stutter to grasp that there is a way that they can create fluent speech without chasing after fluency. Perhaps that is why the hardest challenge of Dynamic Stuttering Therapy is to keep clients focused on the internal processes of creating speech when all the really want is the outcome-fluent speech. In Dynamic Stuttering Therapy, fluency is never the criteria of success. Nevertheless, when the person creates speech in the normal way, the effortless outcome is fluent speech.

As I write this, I am watching the Winter Olympics. I see sportsman after sportswoman focused on their process for their sport as they go for the gold. I think this is a good example of how to achieve success in therapy.

Desire of people who stutter: Becoming fluent

Reason speech is fluent: Focus is on the inner processes of creating speech

This week I am traveling to Tampa, Fla., to the ASHA Special Interest Division in Fluency Disorders 2010 Leadership and Clinical Conference. The title of the conference is “Unique Challenges and Common Themes in Stuttering Assessment, Treatment, and Research”. I am very much looking forward to this conference, because I believe that the time has come for everyone interested in advancing the treatment for stuttering to work together at developing a unified scientific theory.

This conference will be a gathering of clinicians who are concerned with delivering effective therapy to their clients, researchers who want to find answers to the many questions about stuttering, and professors who want to pass on correct knowledge to their students. The Stuttering Foundation of America and National Stuttering Association, two organizations that represent consumers who want and deserve improved treatment will also be lending their support. It should be an ideal forum for exploring new ideas, observations, and findings. A realistic outcome will be the ability of all to look beyond the same ideas and treatment approaches that have been discussed over and over in the past and to find the best direction for advancing the field.

I am planning to do my part as part of a roundtable discussion. As all my readers know, I will be presenting a theory and treatment approach that is different from what most of my colleagues follow. This is not the 1^st conference in which I will be sharing my views. I first presented my seminal theory at a conference in Oxford England in 1993. The reaction I received there and at seminars and conferences that followed was extremely positive. However, my clients who tell me that Dynamic Stuttering Therapy is the most logical therapy that they have experienced don’t understand why other clinicians do not use this treatment approach. Perhaps the late Hugo Gregory was correct in 1993 when he told me that my ideas would not be accepted in our lifetime. Apparently new ideas do trickle slowly into the collective consciousness. That is why I am pleased for the opportunity to share my experiences, learn more about the latest research findings and insights from my colleagues as we brainstorm together with an open mind. By doing this, we should be able to make this a successful conference. I’ll give you my impressions when I return.

We have had many clients who have tried various other therapy approaches before participating in Dynamic Stuttering Therapy. From what I have observed, these clients fall mainly into 3 categories:

1.      Those who had stuttering modification therapy, but were not convinced that this was all they could do to help themselves. They come to Dynamic Stuttering Therapy, because they have decided that, while accepting that they stutter and learning to stutter with a bit less struggle is beneficial, they have not been be able to improve the quality of their communication to the extent they desire. In their heart, they really do want to speak fluently.

2.     Those who were in fluency shaping programs and have tried to do what they had been taught, but became frustrated because it did not work for them. Due to the high hopes they had, they are often skeptical of yet another therapy and fear being disappointed by another unsuccessful therapy experience. Having been dedicated and serious clients, they may also be reluctant to give up the control techniques that they were taught even though they have really not produced the desired results. When these clients come to Dynamic Stuttering Therapy, they are amazed that the experience of speaking can be easier, more comfortable and, of course,  fluent.

3.    Those who did not like the therapy approach they had tried and, therefore, never made a habit of using additional speech or stuttering controls to speaking. When they come to Dynamic Stuttering Therapy, they are relieved that the therapy goals are so logical and uncomplicated. They are no longer reluctant to go along with the therapy process, because it makes sense and feels good.

Some of our clients did not let stuttering affect their lives even before beginning treatment. However, the majority of our clients come to therapy with years of negative experiences, thoughts and feelings related to stuttering. These clients work as much on cognitive processing as on neurological processing. Some of our clients need to make substantial cognitive changes in order to begin to enjoy speaking. My experience as a clinician has shown me the power of individuals to make changes. When the there is a direct relationship between change and desired results, the experience is rewarding.

I am often asked to explain how Dynamic Stuttering Therapy differs from other therapies. The short answer is in almost every way. The more complete answer is that our focus is not on how to, or not to stutter. Dynamic Stuttering Therapy shows clients how to produce speech in the same way that normally fluent speakers produce speech. Naturally, if the process for producing speech is the same, the results are also the same – normally fluent speech. This is logical. People who stutter are capable of changing the way they process speech, so it is also possible. There is a clinically proven cause and effect between speech processing and fluency. That is why Dynamic Stuttering Therapy is the most effective approach for treating stuttering.

For some strange reason, until now people have thought of stuttering as if it were a condition that has little to do with the process of speaking. This is unlike almost any other speech condition in the field of Speech Therapy. If a person has poor vocal quality, the goal of therapy is to change the way the voice functions. If a child has language development problems, we search for the weakness in language processing and work to strengthen it, and so forth. However, with stuttering the goal is either on directly changing the speech itself or, alternatively, accepting that “once a stutterer, always a stutterer”.

There are therapies that do try to manipulate aspects of speaking, such as controlling the rhythm of speech, slowing it down, or controlling breathing. However, while in some cases these approaches might inadvertently cause the speaker to change the interactive neural process of producing speech, they do not actually deal directly with normal speech production. Dynamic Stuttering Therapy directly treats the neural network involved in creating speech.

The normal process for producing speech is essentially automatic. Controlling what you will say or how to say it is the antithesis of normal processing. We do not tell our clients to speak slowly, control their breathing, use gentle onsets or other techniques that require control. We guide them to give up control and show them how to speak automatically and without effort.

Dynamic Stuttering Therapy is an exciting experience, because people who stutter see that within themselves, they have the basic ability to produce speech normally. In some cases they even use this ability some of the time. However, because their focus is so much on the outcome, fluency/stuttering, they are not aware of the inner workings of speaking. Dynamic Stuttering Therapy is a process of self-discovery and change. There is no pressure on our clients to be fluent speakers. However, as they develop greater awareness of their way of producing speech their attitudes and behaviors gradually change. Speaking becomes effortless, comfortable and enjoyable.

Over 20 years ago, I decided to devote all my time and effort as a Speech Clinician to one specific communication disorder – stuttering. It was then that I resigned as a public school speech therapist and opened Communication Therapy Institute. In the early years, I administered a fluency-shaping program in an intensive 3-week group format. At the time this was considered to be the most successful stuttering program available and I intended to do this kind of therapy for years to come. However, after about 4 years of trying to stick to the procedures and goals of fluency shaping as I had learned them, I began to realize that this approach did not take into account many of the aspects of stuttering that I was discovering. So, with care, I gradually made small changes that grew into big changes and evolved into an entirely different way of looking at and treating stuttering.

In 1993, the idea that stuttering was the result of a malfunctioning speech generating system was clear enough to me to write about it and to present it to my colleagues at The 3rd International Dysfluency Conference in Oxford, England. I also decided to write my program in the form of a Workbook and Clinician’s Guide. It was published in 1997 under the name Generating Fluent Speech: A Comprehensive Speech Processing Approach.

During the ensuing years my staff and I continued to treat clients while carefully observing what they did when speaking, how they felt, what they thought and how they were able to speak in the short and long term. Just when I thought I really understood how stuttering and fluent speech was created, the whole process of speaking became even clearer. As this happened, I made changes in therapy procedures. Instructions, activities and even the delivery model were changed. Sticking to my goal of making therapy as simple and effective as possible, I rewrote the workbook that was published in 2007 as Dynamic Stuttering Therapy.

Today we treat people who stutter of all ages. We still believe that the best delivery model when possible is intensive treatment, at least until the person is able to use and reinforce the process between therapy sessions. From then on some clients are able to continue independently, while others require more direct support from the clinician. We no longer do group therapy as we have decided that we prefer to give each client our undivided attention during the learning process. We do, however, recommend group practice and participation in support groups for clients who would benefit from a group atmosphere.

Our mortar and brick clinic continues to receive clients in New Jersey, USA and in Israel. In addition, we are making the same outstanding and effective treatment approach available to people all over the world via video conferencing.

All clients are treated according to the principles of the speech processing approach, the process of change, and the principles of developing new networks for neurological functions on which Dynamic Stuttering Therapy is based. We do not administer this therapy approach because we are loyal to the program. We administer this therapy approach because we are dedicated to our clients and we have seen that beyond doubt Dynamic Stuttering Therapy is the most up to date, most logical, practical and effective treatment for stuttering.