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

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.

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 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.

Many years ago, I presented a research study at The Third International Congress of Fluency Disorders in which I asked both normally fluent and stuttering speakers to develop language in whole word units instead of syllables while producing only a voice or while talking silently (as if the mute button had been turned on). I then asked them to describe the feeling. Both groups answered that they felt choked, tense, and uncomfortable. The people who stutter said that this way of speaking reminded them of stuttering. The fluent speakers reported that this is not at all the way they speak.

This experiment lends support to what I have observed so often in the clinic. Processing speech in the way that people who stutter do, not only makes speech stuttered, it also leads to feelings of tension and anxiety. People tend to believe that anxiety causes stuttering, or stuttering causes anxiety. However, both anxiety and stuttering are the natural outcomes of faulty speech processing. Over time these two conditions become so linked in the speaker’s mind that any feeling of anxiety will exacerbate faulty processing and, therefore, increase stuttering. In turn, a stuttering incident increases anxiety. This leads to increased faulty processing and, therefore, increased stuttering.

Many people believe that the goal of therapy for stuttering is to reduce anxiety. They believe that if the person who stutters could just relax the stuttering would disappear. While it is true that giving up the effort of trying to get words out fluently, may lead to more automatic processing and thus reduce both stuttering and anxiety, it is asking the impossible to try to feel relaxed when you are still trying to control speech.

One of the big frustrations that people who stutter often encounter is being told to relax so that they won’t stutter. Trying to follow this impossible, though seemingly good advice, only increases anxiety.  I have treated yoga experts and people who meditate daily. They are great at relaxing, but the second they try to control their words, relaxation evaporates.

When clients learn to produce speech automatically, without thinking about words and how to say them, the result is not only flowing speech, it is a feeling of comfort and relaxation. Trying to reduce anxiety may inadvertently lead to better speech processing, but there is a more direct approach. Learning to produce speech automatically and without control directly leads to a decrease in anxiety and stuttering.

In an effort to speak fluently, people who stutter, their family and friends are busy trying to find out what outside factors make them stutter. Their hope is to eliminate, change, or learn how to deal with these factors. The emphasis is on external factors. This search is ineffectual because the external factor is not the problem.

The role of external factors is that they may lead the speaker to use a more, or less, controlled process for speaking. It is the individual’s reaction to outside factors and the way their brain functions when these factors are present that actually causes the fluctuations of stuttered speech. Therefore, it is the individual’s reactions, not the catalyst leading to the reactions, that need to change.

Brain functions are not carved in stone. They fluctuate for the better and worse as a result of experience, learning, practice, self-talk and imagination. When an activity has been done in a certain way over and over again, it becomes automatic and consequently more efficient and less subject to influence by outside circumstances.

Taking control over normally automatic processes will always have a negative effect. We see this when we give too much thought to our body movements when we walk or dance. Controlled action makes us clumsier and less flowing in our movement. The same thing happens with our speech.

Stuttering comes and goes according to the degree that controlled processes function to produce speech. By learning how to produce speech automatically, and by accepting the need to speak without control, people who stutter can develop a stable system that generates fluent speech.

In addition, Barbara will be available to work with clinicians looking to expand their expertise in stuttering treatment.

For an appointment, please contact us at barbdahm@gmail.com or by phone, please call us at 201-378-0089 until Jan. 28 and 201-873-2093 after Jan. 28.

Barbara will also be part of a roundtable discussion at the American Speech-Language Hearing Association Conference on Unique Challenges and Common Themes in Stuttering Assessment, Treatment, and Research, which begins on Jan. 29 in Tampa, Fla.

Part of the frustration of covert stuttering is the result of the lack of understanding by the people around them. Parents, friends and teachers may not be aware of the feelings or the difficulty that the speaker is experiencing. Unfortunately, even when they try to explain, people who stutter covertly are too often told that they really don’t have a problem or that it is a psychological problem.

Some people believe that covert stuttering is different than overt stuttering. Speech pathologists have been known to turn covert stutterers away from speech therapy. After all, it’s difficult to use speech modification or fluency shaping techniques to change the speech when no stuttering is heard.

Even people who stutter overtly sometimes fail to understand covert stuttering. They may minimize the problems that the covert stutterer feels, and claim that if stuttering is not heard, it isn’t really stuttering. This only adds to the torment that people who stutter covertly experience.

I want to say unequivocally that covert stuttering is as real a condition as overt stuttering. In both conditions the speaker is not generating speech easily and automatically. Even when stuttering is not audible, there is very real pressure that can be felt in the head, chest, vocal tract, or abdomen. The person who stutters covertly may be very good at changing words quickly so that planned words are not actually forced out, or they may use more pausing so that blocks are not actually heard. However, what is going internally is not very different in overt and covert stuttering. In fact, some speech techniques for controlling overt stuttering, actually lead to covert stuttering, i.e. they result in less stuttered speech produced by a still mal-functioning speech production system.

Effective treatment for covet stuttering usually involves reducing the effort to hide stuttering, but people who stutter covertly do not have to try to stutter overtly on purpose, because this puts the focus on the stuttered speech instead of on the process of speaking. Learning how to process speech is as important for people who stutter covertly as it is for people who stutter overtly. They can learn to produce speech automatically and without effort. Since this is the goal of Dynamic Stuttering Therapy, treatment is just as effective for people who stutter covertly as for people who stutter overtly.

Today, I am a Board Recognized Specialist in Fluency Disorders. I have treated well over 2000 people who stutter of all ages. I realized many years ago that stuttering had many facets that had to be related. This lead me to look at it as a problem of how the speech production system functions. Through the years, with the help of my clients, researchers, other professionals in many fields, a bit of optimistic stubbornness, and faith, I am happy to say that I have unraveled many of the mysteries related to stuttering. Now when people come to me because they stutter, I do not have to guess what goals they need to achieve. Therapy is not a question of trial and error. I know for a fact that stuttering is treatable, and I can clearly see the cause and effect relationship between how the speech system functions and the ability to make both stuttered and fluent speech.

Today I am able to help people who stutter discover that they are capable of speaking fluently with ease and comfort.  I have the joy of watching so many of my clients gain confidence and enjoy speaking. I know I am looking at stuttering from a different perspective than most people. It is the perspective you will read about on my blog. I think you will find it enlightening. I look forward to your comments and hope you will enjoy mine.