Rough Draft of Upcoming Workbook
Preface
When Will and I finished writing our book From Stuttering to Fluency: Manage Your Emotions and Live More Fully ( https://www.amazon.com/Stuttering-Fluency-Manage-Emotions-Fully/dp/1494302586/ref=sr_1_1?ie=UTF8&qid=1549314038&sr=8-1&keywords=from+stuttering+to+fluency ) we re-read the book, looked at each other, and broke out a bottle of champagne. We both felt that we had outdone our expectations and deserved to rest on our laurels. Indeed, the book has been so well received that I decided to write a set of workbooks based on our book and my practice as clinical psychologist and internet coach with adult Persons Who Stutter (PWS). I am writing this workbook together with Dr. Heather Grossman of American Institute for Stuttering (AIS). The working title of this workbook is “Schedule of Step-by-Step Exercises for Recovery”.
This workbook is addressed to the adult PWS with perseverative developmental stuttering. It is equally useful to the Speech and Language Professional (SLP) working with this population. We highly recommend that you read, nay study, “From Stuttering to Fluency” either first or in parallel with using our workbook one. All quotations, with references to specific chapters and pages, refer to our book.
Dear reader, you are reading a workbook. Although it is a good start reading does not equate to working through a workbook. To get most out of this workbook we are inviting you to work through the exercises/worksheets. Exercise P-1 follows:
Exercise P-1
Write the title and the authors on which this workbook is based:
Exercise P-2
Order the book from Amazon
01 Introduction
As we wrote on page 27 “To accurately define and describe stuttering requires much more than its obvious audible and visible aspects. It is not enough to merely describe those aspects that an outsider can see and hear. As well as the blocks and repetitions and body movements there are many facets that remain hidden. And in many cases, people who stutter, do all they can to hide the fact that they stutter by avoiding people and situations. Any definition of stuttering that does not include thoughts, feelings, and actions—including hidden actions as well as actions that are designed to cover up the fact that you stutter is incomplete.”
Stuttering is a developmental condition. It is developed in childhood when a child undergoes traumatizing experiences that he cannot analyze rationally. Due to inborn genetic predisposition, missteps in speech development follow with the child experiencing frustration and a feeling of failure. Epigenetics explains how in these circumstances the genes get expressed. Because of labeling stuttering as bad or awful-- first by society and then himself-- the Child Who Stutters (CWS) subconsciously evaluates speaking situations as dangerous to self, leading to a fight, flight, or freeze response. Moreover, CWS then forms the belief that to be worthwhile a person must be fluent. Thus, he grows into an adult PWS whose life is filled with avoidances, forced and struggled moments of stuttering, and unhealthy feelings of anxiety and shame. Changing the beliefs and emotions, the fight, flight or freeze reactions (based on formerly experienced punishment and fear), and consequent behavior of stuttering is very difficult. A well-structured regimen of Rational Emotive/Cognitive Behavior Therapy (RECBT) together with Stuttering Modification Techniques has frequently proven to be necessary to lead to lasting therapeutic outcomes leading to fluidity in speech and enhancement of life satisfaction.
Our aspirational book “The Joy of Recovery from Persistent Stuttering: Epigenetic Approach” gave the scientific, rational, and philosophical arguments and strategies how to change the beliefs and manage the emotions. This workbook—using a case study as illustrative example—will give a detailed sequencing of exercises to promote recovery from stuttering.
Exercise/worksheet 01-1
What are the main components of stuttering?
From what two disciplines is our stuttering therapy build?
Discuss whether you think it is necessary to address emotions? beliefs? and/or speech manipulation? in stuttering therapy?
02 Overview of the Therapy Experience
In summary, this manual presents step-by-step procedures to recover from persistent stuttering in adults. Four main threads of therapy are presented here and form the acronym MAUI:
Motivation-beginning with hope that recovery is possible, focusing on beliefs/self-talk and ending with persistence when recovery seems to falter. Journaling of measurable progress—together with measurement scales has been shown to be necessary as are daily affirmations that focus on progress.
Anxiety, shame, self-downing and other unhelpful negative emotions need to be managed. This is best done in Rational Emotive Behavioral Therapy (REBT) framework. REBT has been demonstrated to be scientifically sound and is directly applicable to stuttering.
Unconditional stuttering-, self-, other- and the universe acceptance—radical acceptance—has been shown to be pivotal for recovery. Above all, building on the principles of REBT and General Semantics we need to disabuse you from defining yourself by your stutter—you are a unique person of thousands of characteristics and experiences. Why should you think of yourself as a stutterer? Even the use of the less severe label of PWS, should be minimized. At all stages of recovery you need to be able to accept innocuous disfluencies such as the easy Iowa bounces described in the next paragraph.
Immersion in Iowa bounces as we wrote in chapter 9 on Speech Manipulation can be used to perform the functions of Speech Modification:1) voluntary stuttering, 2) cancellation, 3) holding onto/riding out a disfluency, and 4) pulling out of a disfluency. Instead of pre-sets we advocate—in time, and with practice, after you have learned to manage your emotions—to pre-empt stutters with easy Iowa bounces. You can also learn to use elongation of vowels and easy onsets, but only after you have learned to manage your emotions. Beware that you do not use the above Speech Manipulation Techniques to hide your stutter.
The workbook is based on scientific knowledge and will be updated as the scientific knowledge evolves. Each step in the recovery process will be based on or derived from scientifically accepted results and spelled out in enough detail for you, the informed PWS, to be able to execute it. We will liberally use justification for exercises taken from the “From Stuttering…” book. Therefore, you need to be familiar with it and be able to refer to the specified pages.
This is a workbook. It will contain many exercises. You, my dear reader, may as well start to get used to doing exercises.
Exercise 02-1 Top down description of REBTS
In your own words describe what are the four threads in therapy
Motivation
Anxiety Reduction
Unconditional (Radical) Acceptance of Stuttering and Self
Immersion in easy Iowa bounces
Exercise 02-2 Pass your description of MAUI past your therapist or compare with the workbook definition then repeat exercise 02-1 forming shortened version of therapy
In your own words describe what are the four threads in therapy
Motivation
Anxiety Reduction
Unconditional (Radical) Acceptance of Stuttering and Self
Immersion in easy Iowa bounces
Exercise 02-3 For a week repeat a short definition to yourself of MAUI five times a day
Upon getting up
At breakfast
At lunch
At dinner
At bedtime
This is the end of excerpt 1