Wednesday, February 3, 2010

To Control or Not to Control.

Out of Control.

In an earlier entry, I cited the following quote from long-time speech therapist Barbara Dahm: "My firm belief is that people stutter when they are exercising control over speech processes that are meant to function on an automatic mode.” A long and fruitful discussion earlier this week has caused me to revisit this quote sooner than I would have expected. I'd like to suggest that the statement above is not only wrong, as in backwards, but it is inside-out as well, if such a thing is possible.

Let's look at a typical stuttering event. A stutterer says "My name is P-P-P-P-P-........P-P-P-P-P-P-P..... aul." Throughout the rapidly repeated "P" sounds, the speaker has shown tenseness in the facial muscles and an abnormally strong breath exhalation on each "P" effort. One could say that these tense, strained and unnatural efforts are part of the maladaptive "exercising control" that Ms Dahm speaks of above. This is a plausible explanation - let's see if it is the best explanation.

Stuttering is immediately recognized as wrong by the speaker at an early age. The stuttering literature gives many examples of young children straining in self-knowledge at their inability to speak works naturally and effortlessly. Certainly, adults are fully able to recognize their own disfluency, even if sometimes they can block it out.

In the example above, the stutterer begins to say his name, and falls into a stereotypical repeat pattern. We might say, for Ms Dahm (if we understand her correctly) that upon reaching his name, the stutterer has assigned to conscious volition a physical/mental process that can only be accomplished by sub-conscious, non-volitional control systems. Again, this is a plausible proposal. Now, let's look at it from another direction.

I will propose here that something very different has happened. The strain and other non-natural behavior seen in stuttering is not found in fluent, non-stuttered speech, and can be seen as - and may, in fact, sometimes be - volitional. But let's go back to the "stuttering moment" above and read it in a different way. The speaker begins his sentence, reaches his name, sounds the "P" and blocks. He knows from experience that this will lead to a series of repeats - the stereotyped stuttering. If he wanted to "take control," what would he do? He might push harder, in some sense, as stutterers so often do. This just increases the tension and anxiety level, and provides positive feedback to increase the stuttering, as Ms Dahm's model might suggest. Here is where I differ.

To gain control, the stutterer always has another choice. He or she can simply stop. Stopping is the ultimate control. If you don't want to stutter, you can always just stop, rather than falling into the stereotypical stuttering pattern. In the hypothetical sentence above, the speaker could say "My name is P-..... aul," or "My name is P-P-P-..... aul. In either case, as soon as the stuttering event is triggered and started, the speaker recognizes it as soon as possible and simply stops. This form of control would not stop the stuttering impulse from occurring, but it has the capability of lessening the symptom dramatically. So why don't stutterers do it? Why don't they even try to "exercise control" and remove themselves from stereotyped pattern or repeating or prolonging that is experienced as so painful?

So here is my counter-hypothesis to that of Ms Dahm. The stutterer doesn't stutter because he/she seeks to take control of the natural, sub-conscious speaking process; the stutterer stutters - in those stereotypical repeats and prolongations - because he or she instinctively seeks to give up control of the disfluency impulse to the (flawed) natural, automatic process. That is, the stutterer does the counter-intuitive - repeating the same letter-sound over and over, in an unsuccessful attempt to move on to the next sound - because he is under a natural compulsion to let the automatic process do its proper work.

Human speech evolved over hundreds and thousands of generations. We learn language and speech naturally, without any conscious effort of teaching, and without conscious effort on our own part to "learn." Our brains are wired to produce speech like they are wired to produce walking on two legs. Should be be surprised that impulse to speak without conscious effort would be a strong one? Wendell Johnson famously said "Stuttering is what stutterers do when they try not to stutter." Ms Dahm seems to fall comfortably into the Johnson school of stuttering theory.

Let me rephrase Johnson's much-cited quotation to my own liking: "Stuttering is what stutterers do, in spite of the fact that they don't want to do it." From that perspective, we can ask new questions. When stutterers know that their speech follows a pattern of long repeats and prolongations, why do they not take control and stop? It is the longest symptoms that are felt to be the most disruptive, and most noticed by listeners/observers. One might suggest that the stutterer is hoping to get through the dysfluency sooner rather than later. In fact, stutterers themselves may say that very thing. That doesn't stop us from pointing out that after years and literally thousands of failures to get it out "sooner rather than later," that reading of the situation doesn't impress.

The stuttering literature is full of citations of stutterers - and observers - describing a "loss of control" during stuttered speech. Are both stutterers and observers wrong in their interpretation? Let's take another tack on this subject. There are just a few basic schools of stuttering speech therapy today. The mainstream methods seem to agree on their basic approach - they seek to teach the stutterer skills to consciously control his or her speech. Slow speaking, controlled breathing, relaxation.... these are all exercising control. Which, of course, Ms Dahm believes is the cause of the problem in the first place.

Both fluency shaping and stuttering modification require the client to take control of his or her speech production in a careful, conscious way. And, interestingly, those who go through both of these therapy programs sometimes find that the effort to suppress their stuttering through such active control methods grows tiring to the point that they choose to give up the effort and revert to stuttering. How can that be?

If I am right, and stutterers stutter to the degree they do because of a natural impulse to allow speech to function automatically, then both of the above observations make sense. First, it requires conscious control of speech production (as taught in speech therapy) to increase fluency. Second, the impulse to allow the natural, sub-conscious generation of speech is so great that it can overcome an otherwise successful therapy program that relies on taking the speech generation away from its natural source and assigning it to constant, conscious monitoring and modification.

So there you have it. I can't prove I'm right, but my hypothesis is in concert with the observations I've noted above. I would argue that it is superior to the Dahm/Wendell Johnson hypothesis on multiple levels. It's a start.

*** Tip 'o the hat to Jamie R. for helping me clear my thoughts on this matter. All errors, misunderstandings and general BS are mine alone.


  1. Thanks Mark! I so enjoy reading your blogs and discussing our views on stuttering. Keep up the good work!

  2. It's the discussion that keeps one person from going down blind alleys.

  3. There are multiple ways to control your speech. One is stopping, another is what most people do when they stutter. Just because something isn't "stopping" doesn't mean it isn't a method of control.

  4. It has often been noted in the literature that stutterers often don't know when they stutter - they are incapable of reporting accurately on their own stutter frequency. That hardly suggests "control."

    The is no suggestion above that stopping in mid-speech is the ONLY means of control. The fact is that many stutterers report a sense of being "out of control" when they stutter. In generic terms, being incapable of stopping oneself from doing something you don't want to do is not control, in any rational sense of the word. One method that would define control - stopping volitionally - is rarely seen. Why? One could always say P...eter with far less strain and pain than P-P-P-P-P-P-P-P-Peter. The fact that the later is vastly more common than the former needs explaining.

  5. I think that Mrs Dahm's theory is greater than yours... Of course, I can never claim it's "true" because I don't know the feelings and symptoms of every stutterer on the planet. However, I can tell you what I feel from my own experience as a stutterer. For me pushing "as hard as I can" through a difficult sound ("P" is a wonderful example) is almost entirely a voluntary process.. I know that I do it because I try to "escape" from the difficulty and go on as quickly as possible.. and it's completely intentional. For me it's actually more like poor self-discipline. I know I shouldn't do it but I do it anyway because that seems (by intuition) like the fastest way to go and I feel ashamed when I keep people waiting for me to finish. It's just that I know no OTHER way of dealing with the blocks. If I find one, I would surely try it