Lifespan of Stuttering CORRECTED

CORRECTED FILE: Stuttering throughout the lifespan

Epigenetic beginnings

•      We inherit genes that predispose us to disfluencies

•      When these genes are expressed due to our environment, be it in the womb or in very early childhood, we have dysfluencies in our speech

Early speaking experiences

•      At the beginning our (Persons Who Stutter-PWS) disfluencies do not differ much from any of the other children who learn to talk. We have a few repetitions here and a few pauses there. There is nothing wrong with pa-pa, ma-ma or a ___pause

•      We are somewhat slower in achieving language skills

•      Maybe our speech contains more repetitions and longer hesitations. Nothing wrong with that/

•      Where things start to differ is that a) we, or our caretakers, get frustrated with the slow process of acquiring “normal” speech and b) we, or our caretakers, are requiring perfection. Instead of having space to develop our speech, we or our caretakers, say “talk slower” which in our heads gains the added connotation “there is something wrong with our speech”

•      Having proclivity to think crookedly, we do not realize that for us “normal” speech could well be speech that include easy repetitions and involuntary pauses. If we could stabilize this state of only having some easy disfluencies and some pauses, there would be no harm, no foul. The little bit of repeating, the little bit of longer it may take, and the little bit of teasing (I mean little bit) we could have been toughened against by parental love or kind logical psychologists or speech professionals.

•      However, we and or our loving and overconcerned caretakers—being the Forever Fallible Fricked-Up Human Beings that we are--over focused on the disfluencies. Even modern Speech and Language Therapists often count the percent of syllables stuttered and try to measure the rate of speech—unless we have a Southern Drawl. Erroneously and counter productively our conscious or subconscious minds, with and without the help of our caretakers, social milieu, and therapists, assign to easy repetitions and involuntary pauses extreme negative value and/or label them as awful. Instead of our erstwhile communications being non-judgmental interactions, full of love, playfulness, and frivolity the communications become damn teaching lessons of how to talk better. This is really punitive. Speech is associated with danger and punishment.

•      Each speaking situation becomes a beating with a whip, real painful. This pain travels through the limbic system and is stored in amygdala (the reptilian brain). No wonder even capable neuroscientists tend to say that memories stored via classical conditioning cannot be reversed. We admit it is hard, but not impossible. It is hard because the response through ears and eyes goes directly through the limbic system and there are so MANY OCCASIONS WHEN THIS PUNISHMENT IS METED OUT.

•      As if this would not be damaging enough the Pre-Frontal Cortex joins in and makes a ridiculous,  magical, illogical leap and defines ourselves .by this one negative characteristic and labels ourselves as stutterers leading to the conclusion that we are somehow damaged, children of a lesser god, pieces of guano, or less worthwhile than persons who do not stutter. Take your time and consider what sense does that make?

•      After the classical conditioning the repetitions become more forced, more struggled and the pauses longer and more tense. This results in our feeling of loss of control, of being stuck either in a repetition or a pause (note some pauses are with sound, some without.)

Escaping the Condition of Being Stuck

•      Being out of control is the exact opposite of being safe. Safety is defined by us that we are in charge and can defend ourselves not sliding into an involuntary state of fight, flight, or freeze. (We associate fight as the forcing of struggled sound, flight with avoidance of a sound, work, or speaking situation, and freeze with a silent involuntary block.)

•      As if we were not damaged enough by classical conditioning at our learning how to talk, we also have to face the boogey man, the operant conditioning. Operant conditioning occurs when we escape from a painful situation such as being stuck or when we get something we want. What we want is being understood and respected. In operant conditioning we do something such as snap fingers and when that releases us from a block we attribute the release to the snapping of the fingers. Unfortunately, some operantly induced conditions are purely accidental while others, solving the solution in the short run wreak havoc in the long run. For example, you might escape a feared word by substituting a synonym which appears to be a good short-term solution. But in the long run the speech may become awkward and take away from the focus of the topic of the conversation. Snapping ones fingers to get a word out, may work for a while, but eventually becomes just an involuntary secondary (concomitant) action making the speaker in search for another bizarre movement of the limbs. These actions such as snapping of the fingers become involuntary and detract from our communication and dignity.

Acceptance of a well-organized approach to therapy such as taken from Rational Emotive Behavior Therapy (REBT). Other approaches from modern psychology such as Cognitive Behavior Therapy also work.

•      First let us see why some people recover from stuttering on their own. There are various possibilities. Stuttering probably has a genetic component and learned components. In persons who recovered spontaneously, the genetic component might have been outgrown. Other possibility is that their learned components, both classical and operant conditioning were not too deeply ingrained. Let us entertain a third possibility that some people’s temperament was such that they were, with or without help, more resilient.

•      Operantly conditioned habits such as avoidances, some kinds of forcing, secondary symptoms etc. can be straight forwardly (although not always quickly)  eliminated by disputing and challenging irrational/unhelpful beliefs and attitudes and then going out in the real world and acting against them.,

•      With effort and time the learned part: the forcing, struggling, hard contact blocks, and elongations can be minimized, whether acquired as part of classical or operant oconditioning. But, as always in vivo exercises are necessary.

•      With effort and time feelings of inferiority, shame, anxiety, guilt, time urgency, low tolerance of frustration and discomfort, anger at self or others, and the feelings of helplessness/hopelessness, and the avoidances can be radically cut back

•      We start with accessory (secondary) behaviors that appear to be most amenable to minimization via disputation of unhelpful ideas and then going out in the public and doing the assignments that are designed to counteract these ideas.

Conditions Leading to a Decision Whether to Work on Stuttering Components

•      As Yogi Berra said “when you come to a fork in the road, take it.” You have a choice whether to work on your speech to minimize when you come to an out of control forced, struggling repetition or a uncontrolled tense block with or without sound you could ignore them and calmly stumble forward to communicate what you wanted to say. Probably those who spontaneously recover from stuttering probably did do that.

•      The rest of us were quagmired in unhealthy negative emotions and unhelpful negative beliefs that stood in the way of recovery from stuttering by keeping the speech struggled and forced and the blocks tense.

•      The unhealthy emotions include shame, guilt, speech anxiety, instead of merely healthy negative emotions of regret, personal concern, and concern about speech. (A detailed discussion and listing of all the unhealthy negative emotions due to its length is the subject of another blog.)

•      Likewise unhelpful negative beliefs are delved into in another blog. Let us just name a few such as Hopelessness, Awfulizing, Self-Downing, and Intolerance of Frustration and Discomfort.

•      The choice that we have is to decide whether to eliminate unhelpful negative beliefs, unhealthy negative feelings, struggled forced speech and tense stuck blocks.

Summarizing the Choice

•      We have a choice philosophically to start with

•      Stopping awfulizing stuttering

•      Toughening ourselves so we can stand frustration”

•      Learn to love ourselves. We don’t have to put our selves down, even when we don’t like some of our acts.

•      And practically embrace our humanity by accepting that we are Forever Fallible Fricked-Up Human Stuttering Beings.

•      We also have a choice

•      To stop feeling ashamed

•      To accept that stuttering does have its inconveniences that we can well tolerate

•      And turn anxiety into concern

•      With practice we can also minimize

•      Struggling, forcing and the tension in our speech

•      And the avoidances which so frequently ruin our communication

Acknowledge that Real Work on Recovering from Stuttering Involves Our Relationship to Others

•      We, People Who Stutter (PWS), just like all other people have a great desire to be accepted by others

•      We can pursue being accepted by others as long as

•       we see the desire for what it really is. It is a strong desire and not a need. When we turn the desire into a need and our brain goes bonkers and we tend to stutter more and propagate the stuttering.

•      we accept that time to time we will turn the desire into a need. When this happens we have to turn the need back into being only a strong desire.

•      we best work relentlessly until we clearly see that in individual situations it only is a desire to be accepted. How do we do this? By thinking scientifically and asking three pertinent questions: 1) Does it correspond to empirical evidence? 2) Is it logical? And 3) Does it help me?

•      We are very sensitive to others’ opinions especially teasing and bullying. What to do? Toughen yourself, dude!

•      Accept that there will be unpleasant people around. Don’t pay much attention to what they say.

•      We also can desensitize ourselves by, for example, doing anti-shame exercises. By proving to ourselves that we do not die of shame.

•      We can call on our resiliency: when we don’t live up to our expectations and “fall down” consider this a learning opportunity. Think about what you could have done differently. Remember, it is not about how many times you fall down, it is about how many times you get up.

•      There are some practical drawbacks to stuttering, some discomforts, some frustrations.  Tough shit! Learn that in our universe shit happens. Let the on-lookers smirk if they want to. “Sticks and stones will hurt my bones, but I will learn, promise to learn,  not to let words hurt me.”

Final Words of Advice: Go balls out to recover from stuttering,

•      Work on the belief that recovery is possible. “I have met people who say it is, I have met those who say it is not.  They are both right.”

•      Commit a huge amount of energy and a lot of time to work on exercises to overcome your unhelpful beliefs and unhealthy ideas. Find authors like Lynn Clark and Albert Elis.

Summarizing What We Said about Lifespan of stuttering

•      The first period of our lives we, due to our genetics and environment succumb to the various components of stuttering: 1) uncontrolled struggling, forced repetitions; 2) uncontrolled tense forced blocks; 3) avoidances (which become almost involuntary); 4) secondary stuttering phenomena (involuntary); 5) unhealthy negative emotions; and 6) unhelpful negative beliefs.

•      Some people recover spontaneously/

•      Some are helped by commonly practiced therapies.

•      Others need to specifically learn to manage emotions and develop healthy attitudes, recover from stuttering, and live fully..

No matter what you do, you can still unconditionally accept yourself and love yourself.

(More details on self- and formal therapy will follow.)

 

Real Acceptance of Stuttering

Acceptance Is the Same Height as A Human Being

Basic acceptance of reality

•      Sun rises in the East

•      Life is challenging for everyone

•      We are by nature fallible, limited, non-perfectible

•      We cannot make demands on universe, others, and even ourselves and expect that these demands will be fulfilled

•      But we can strongly desire certain goals and in most probability achieve them or come close

Acceptance of reality about stuttering

•      Right now you stutter the way you stutter right now; acknowledge it

•      You can’t demand it to change, but you can strongly desire it to change and work towards changing it

•      You can almost instantly realize that stuttering is not awful: 1) it does not cause unbearable pain, 2) you can still enjoy many, many other things

•      You can decide not to beat upon yourself (deprecate yourself) for stuttering

•      You can think hard and realize that all people have equal worth in the eyes of the universe (we all are born, live, and die).

•      Stuttering can’t make you less worthwhile.

•      There is no law in the universe that you should not stutter.

•      Stuttering causes some discomfort-but you can stand it: you have stood it so far

•      In time you can minimize stuttering severity and frequency, but there is no guarantee that you will totally eliminate it.

Acceptance of Rational Emotive Behavior Therapy (REBT) ideas about stuttering

•      Stuttering probably has genetic component and a learned component

•      With effort and time the learned part: the forcing, struggling, hard contact blocks, and elongations can be minimized

•      With effort and time feelings of inferiority, shame, anxiety, guilt, time urgency, low tolerance of frustration and discomfort, anger at self or others, and the feelings of helplessness/hopelessness, and the avoidances can be radically cut back

•      The accessory (secondary) behaviors can be practically eliminated.                                   

Acceptance That You Have a Choice

•      You have a choice whether to work on your speech to minimize struggle and unhealthy negative emotions or do nothing.

•      You have a choice which approach to use.

•      Not learning about the different approaches and not using blood, sweat, and tears to apply a new approach in your self-therapy (if your present one is not working) is a choice. Not doing anything is a choice to remain in the same state of stuttering. You have a right to do so. YOU can live a good life, whether you stutter or not.

Summarizing Acceptance

•      Don’t demonize stuttering

•      Don’t awfulize it

•      Don’t pull off an “I-can’t-stand-it”

•      Don’t deprecate or down yourself because of stuttering

•      Stuttering does not make you a child of a lesser god

•      Don’t trivialize it

•      Accept that stuttering does have its inconveniences

•      Humanize stuttering

•      Learn to live with it in daily life until you decide to do something about it

Acknowledge and Learn to Accept Our Relationship to Others

•      People Who Stutter (PWS) have a need to be accepted by others

•      See this need for what it is-a strong desire that we turned into a need

•      Understand that we can turn it back into being only a strong desire to be accepted

•      Work relentlessly until it only is a desire to be accepted

•      We are more sensitive to others’ opinions especially teasing and bullying

•      Accept that there will be unpleasant people around

•      But we can toughen ourselves

•      We can call on our resiliency

•      There are some practical drawbacks to stuttering, some discomforts, some frustrations

•      Learn to live with it in daily life until you decide to do something about it

Final Words: Accept Yourself Unconditionally

•      Don’t fall for conditional self-esteem, don’t say “I can esteem myself because I can do this or do that, have this or that, am liked by this or that”

•      No matter how you fail understand, you can still love yourself

•      We are by nature fallible, limited, non-perfectible

•      We cannot make demands on universe, others, and even ourselves

•      We can choose to work diligently to recover from stuttering

 

True Grit and Recovery

For me nothing has come easy in life. The successes in my life have been based on true grit. The dictionary defines grit as: “courage and resolve; strength of character.” An example of how this is used is "he displayed the true grit of the navy pilot". The synonyms are: courage, courageousness, bravery, pluck, mettle, mettlesomeness, backbone, spirit, strength of character, strength of will, moral fiber, steel, nerve, gameness, valor, fortitude, toughness, hardiness, resolve, determination, resolution.

After I helped to resolve some family problems, I decided to restart my blogging. Not being an expert on computers I encountered website managing and technical problems with my computer. It took true grit to sort everything out.

This is my restart in the blogging effort. Phew!

If this is successful, I will muster enough courage to proceed in constructing the coaching directions to help others recover from stuttering. Wish me luck. Since, we are all different (idiosyncratic) the process of helping others to recover from stuttering is complex. A series of blogs will follow how I explain my clients what they need to do to recover from stuttering.

Thoughts on Similarities Between REBT of Stuttering and PTSD

Some random thoughts from a rough draft of my upcoming book:

Rational Emotive Behavior Therapy of Stuttering  is based on recognizing that stuttering that lasts in adulthood is based the following factors. 

First, we acknowledge that there may be a genetic predisposition to stutter. A set of genes appears to cause us to have some difficulty in acquiring speech and possibly another set of genes that makes us be oversensitive. I use we because I had a very severe stutter even though I now seem to have recovered from it.

Second, there is a lot of common in stuttering with Post Traumatic Stress Disorder (PTSD), because we have experienced systematically a lot of traumatic speaking experiences which have had a definite effect on our cognition, feelings, and bodily reaction. Recent literature shows that there is an reciprocal interaction between amygdala the seat of feelings that becomes aroused when there is a danger and pre-frontal cortex.. The amygdala when aroused triggers strong emotions and sends agitated signals to neurotransmitters throughout the brain, including the Broca area, where speech is formed, and which is located in the Pre-Frontal Cortex. Amygdala's reactions are useful  to activate the emergency response, the fight-flight response . You can see a picture of the brain and this process in the illustration associated with this blog. But PTSD causes over reaction in amygdala and scrambled reaction in Pre-Frontal Cortex. 

In stuttering a traumatization also occurs. A young child is constantly seeking the approval of his parents, older siblings, and other members in his close-knit circle to satisfy his feelings for the need to belong. When our speech development lags, our parents kindly try to instruct us and model the right kind of development. No matter that they do it with love, they call attention to our speech. Being anxious sort, we strip away the love and focus on our slow speaking progress. We feel their concern and we, being oversensitive, interpret subconsciously it as a threat  of abandonment and proceed to construct a fear for our safety. Not are we only traumatized we also, as a consequence of making inadequate progress in our speech, start to deprecate ourselves. This self-downing also results in traumatic feelings.

Our impatience and our low tolerance of frustration often coupled with the concern  and the impatience of our parents intensifies our negative feelings and is soon interpreted as punishment. Speaking situations become dangerous encounters. No matter how minute or severe our deficiency in developing to speak is, we are classically conditioned to fear certain speech situations. This classically conditioned fear is stored in the amygdala. 

What we develop is an unfortunate chain reaction: a) a stressful speaking situation is b) interpreted by the amygdala as a threat to our safety and c) i, the amygdala, overreacts and messes up the fine tuning necessary in Broca area to form fluent speech. The only real hope is to have the executive functions in Pre-Frontal Cortex to take over and calm down the amygdala. This is what is done by working on beliefs as REBT does.

Next time I will talk about operant conditioning and the secondary stuttering.