"Soul-utions" In Therapy: For People Who Stutter

Editor's Note: The following ideas are adapted from “Soul-utions for People Who Stutter - Stuttering Therapy” by Phil and Uri Schneider, in Stuttering: Inspiring Stories and Professional Wisdom, 2012.  These ideas offer a soulful frame for understanding stuttering and its treatment (both in terms of the “BODY” aspects of stuttering and the “SOUL” aspects of stuttering).

In the spirit of the proverbial saying, “There is nothing new under the sun,” this post will remind us what we already know about the most universal and deepest truths about stuttering, and helping people who stutter. 

Let’s be clear, helping a PWS (person with stuttering) is more than working on mechanics.  Rather, the purpose of our work is to liberate and enrich the human experience through increased freedom and power of speech.  Our work, therefore, is a dynamic process: working from the outside-in and the inside-out, planting values and building great communicators by drawing out the intrinsic greatness within each person.

BODY:

Stuttering is a neurologic, physical condition which generates unpredictable, involuntary, intermittent interruptions in the automatic, effortless, seamless transition from one sound to the next (or from silence to sound).  The frequency and intensity of these interruptions vary widely from moment to moment.  We know enough to know that they are not simply caused by emotional or cognitive variables.  We also know enough to say stuttering is multifactorial and can be exacerbated by any number of triggers, including but not limited to: speech intensity, speech rate, fatigue, emotional arousal, hormonal changes, language complexity, and social-emotional circumstances.  The speaker can have a clear flow of thought and motor planning, and still experience interruptions.

Consider the typical speech motor system, which could be likened to an intricate ballet performed in super-fast speed (vocal folds the size of your pinky fingernail move hundreds of times per second!).  As is true in dance, each articulatory posture in speech needs to transition with flow from the one which precedes it while, at the same time preparing for the posture which follows. The physical aspect of stuttering introduces unpredictable disruptions to this intricate ballet – even though the speaker “knows” the dance well and may have performed it tens of thousands of times before, without a single glitch.  The person who stutters, knows what they want to say, and may have said the words fluently before.  But stuttering is the experience of unintentional interruptions to that regular flow of speech. There are three different types of disfluencies - “hesitations”, “repetitions” and “prolongations”. Any person who stutters, may have one or more of these disfluencies which characterize their personal stuttering condition. These terms - “hesitations”, “repetitions” and “prolongations” - are descriptions of the surface behaviors which are the observable representation of the physical aspect of stuttering.  The traditional assessments use percentage of syllable stuttered (%SS) as a surface measure of the physical behaviors of stuttering.  But these terms and assessments only relate to the physical, “body” aspect of stuttering.  When working with a person who stutters, we need to tune-in to things that cannot be seen, heard or measured by outside observations.  For the experience which cannot be seen or heard, is as real, and if not as challenging, even more so, than the moment of interrupted speech may be.

BODY MEETS SOUL:

To understand the personal human experience with stuttering, one must consider the impact of these physical interruptions on communication and self-image.  

These unpredictable and undesired physical interruptions can press upon the speaker’s desire to express himself and reduce his desire to freely connect with others. Over time, this condition can even lead people to avoid speech communication altogether, stifling social, academic and vocational development and opportunities.  If this happens, the person who stutters loses more than their fluency.

Their soul becomes sore. They may lose faith in the pursuit of their life dreams, and damage their sense of purpose and sense of self.  Stuttering can make us feel hopeless and helpless: out of control of our both bodies and our lives.  When we feel robbed of our sense of inner dignity and self-determination, we can develop feelings of shame and humiliation.  Interestingly, unlike other speech disorders (like articulation), stuttering can be exacerbated by increased drive to be heard.  In fact, if you don’t talk, you can’t stutter. Ironically, stuttering affects those who commit to communicating and sharing their inner thoughts, feeling and ideas with the world! Peculiarly so, people who stutter usually do not stutter in speech which is not genuine communication.

Now, let’s consider how speech communication, stuttering and speech therapy are really the intersection of meta-physical (soul) elements and physical (body) mechanisms.  The physical mechanism of speech communication includes movements, airflow, sounds, words and grammatical structures.  But we must not forget that these physical elements coalesce to serve a special, meta-physical (“soulful”) purpose.  Universally, speech communication is a means to understanding, which opens the door for compassion, which leads to relationships and connection.  Speech communication is the song of soulful communication; a gift endowed to mankind above and beyond all other creatures on this planet.  Through our speech communication, we fulfill our inner drive to express our personal thoughts, feelings, needs and desires, and feel connected to others through a two way symphony of sound and expression. When we speak-out our thoughts and feelings through our voice breath, in exchange with other people, we really build shared-bridges of meaning, between ourselves, our inner experiences and those of others’.

TREATMENT APPROACH:

Now, as we understand the experience of being a person who stutters as an integration of “body” and “soul,” then speech therapy must also take a body and soul approach.  The “body” of therapy focuses on the physical mechanics of speech production and the exercises designed to enhance the ease of speech and reduce the frequency and severity of interruptions.  This includes physical training needed to break old behavior patterns and establish new ones.  It’s significant to note that the physical aspects of therapy have been the primary (sometimes exclusive) focus of our professional tradition, but it is certainly not the only part, and probably not the most meaningful part of the healing process.

After all, we must also address the underlying, meta-physical “soul” aspects of why we communicate and what we think and feel about our speech, about ourselves as communicators, our self-worth and most of all, our true purpose in the world.  In reality, these soul-ful elements define the purpose for the work and which motivate, direct, and drive the hard work needed to modify physical mechanisms.

Other "soul-utions" include more general dimensions of “determination” and “persistence.”  Determination helps to prevent delays in follow-through. Delays in taking action can lead to a loss of enthusiasm.  Quick follow through helps to capture the focused clarity and energy needed for success. Persistence is needed to make ongoing sacrifices in the present based on the anticipation of meaningful rewards in the future. “Determination” and “persistence” help a person stay on course in spite of pressure to fall back into the status quo.

CLOSING THOUGHTS:

Our experience continues to demonstrate that our role in working with the PWS is so much more than treating the physical aspect of stuttering.  In fact, if we treat only the superficial symptoms of stuttering, we risk doing harm. We must look at the body and the soul of the issue, in the same way we must look at the people who seek our help.  They are not bodies or client files.  Each one is an entire world of dreams, interests, pain and loss and their inner soul is looking to restore its shine.  We must be focused on helping people; we must focus on helping people transcend their stuttering through wholistic understanding, care, acceptance and of course, speech strategies. If we treat people in this way, giving credence and attention to both their physical and non-physical realities, then we can be partners in the exciting and ongoing process of real recovery.

To learn more about Uri and Phil Schneider's work and services, visit: Schneider Speech