Monday, March 22, 2010
The following passage comes from George H. Shames and Herbert Rubin in the book Stuttering: Then and Now.
"Talking about stuttering is a social taboo. Even in households with disfluent children, overt commentary is the exception rather than the rule. Taboo subjects tend to surround themselves and the members of the problem with a sense of shame and guilt which, together with a sense of victimization and helplessness, can continue through adolescence into adulthood.
For adult stutterers the social ritual proscribes any comment about disfluent speech, with the possible exception of the stutterer himself, in the form of a joke or an excuse. Neither the family nor friends risk the embarrassment of commentary, as if they were confronting the emperor without his clothes, conspirators in denial."
This is a remarkable statement. Let's look at your average stutterer: filled with guilt and shame, helplessness and a self-pitying victimization, making jokes or excuses for their behavior. And the stutterers family and friends? They can only feel embarrassment when faced with such a person.
I'm 55 years old. As a child, my parents rarely talked about my stuttering. Not out of a sense of embarrassment, but because there was rarely anything to talk about. What would you say to a blind child - "How's the lack of sight going?" If I wanted to talk about my speech to my parents, I did so. Otherwise, they treated me like a son, not a stutterer. I knew I stuttered, they knew that I stuttered, and we all dealt with it. There was no taboo, no guilt, and no shame. I was often frustrated, but certainly never thought of myself as a victim, and helplessness never entered my mind. I stuttered - I wasn't paralyzed in a bed.
As to friends - I can't say what was in their minds. but as with my family I rarely discussed my stuttering with them. No denial, no avoidance, no shame or guilt. Just a simple principle - it wasn't there problem, it was mine. To be a friend - or a girlfriend - was to be a person who could deal with it. If a person found it embarrassing to consider, then I assumed that they would not choose me as a friend.
Within the Stuttering Industrial Complex, there is a strong contingent that loves to talk about fear, guilt and shame. And anxiety... don't forget anxiety. I've certainly lived with the fear of stuttering, but the fear was situational. I didn't spend my childhood living in fear, and my adult life has been remarkably ordinary. Guilt? Why in the world would I feel guilty? Stuttering is a pain in the ass - not a sin or a crime. As to shame, there's been some of that over the years, but again it was always situational. At my worst - those memories that stay with me to this day - the feelings of shame experienced when stuttering were generally gone the next day. As with a broken leg, you remember that it happened, but you don't remember the pain.
It is my impression that the people who want to peddle guilt and shame to stutterers belong to the school that holds psychology at the heart of stuttering. And they need fear, guilt and shame to motivate the condition. Are there stutterers who see themselves as victims? Pathetic, self-hating creatures surrounded by pitying observers? I'm sure they're out there. I'm also sure that many stutterers are well-balanced people with no need to wallow in the misery expected of them by stuttering "experts."
Friday, March 19, 2010
Friday, March 12, 2010
There have been many proposals for the cause and nature of stuttering. From thick tongues to parental misdiagnosis and brain mis-wiring, the history of the topic is littered with a long list of hypothesis, from the ridiculous to the reasonable. Too often in the past, these proposals were made with little knowledge of the condition, and supported without any effort to test them against observations.
There are certain observations that are repeated throughout the stuttering literature. Stutterers are fluent when speaking in unison with others, anxiety triggers stuttered speech, many children recover from stuttering at an early age, etc. Any hypothesis proposed to explain stuttering needs to account for these, and other observations - the hypothesis cannot conflict with the facts as we know them.
Of the most significant facts of stuttering is that approximately five percent of children go through a period of stuttering, and approximately one percent continue to stutter through their lives. Any proposed cause or explanation must be consistent with these numbers.
We can start by asking whether the numbers are correct. Over the last 100 years, there have been many estimates of stuttering prevalence. Although it was once claimed that some cultures did no have stutterers or words for stuttering, it is now believed that every culture in the world knows stuttering has has stuttering members.
Beyond the existence of stuttering, we could question the one percent prevalence of stuttering adults. While good numbers are not available for every tribe, clan and ethnic group, we can still say something about the prevalence of stuttering is such populations. There is no group in the world in which the prevalence of stuttering is thirty percent. In other words, there is no population in which stuttering is absent, and none is which stuttering is dramatically higher than one percent. We can say with reasonable confidence that if there was a culture in which stuttering was much more common than one percent, we would probably know about it.
So let's take the one percent estimate, and use it as a first approximation test of stuttering hypothesis. Early in the twentieth century, the influence of Freud was strong, and psychoanalytic theory was used to propose that stuttering resulted from oral-sadistic tendencies (whatever that means). We can ask, if it is true that such tendencies develop during early childhood, is it plausible that they occur in one percent of children across dramatically different cultures on different continents? Does that pass the sniff test? Different religions, different family structures and different child-rearing practices would all have to produce this same condition at the same rate. It's hard to imagine that even the confirmed Freudian of the 1920s would actually maintain such a belief when confronted.
We can ask the same question of any behavior-based hypothesis. Whatever causes the behavior - parental disapproval of normal disfluency, mistaken self-judgement of speech competence, etc, Is it plausible that this very specific speech disorder could be produced at the same rate throughout the many different cultures of the world by these methods? If the origin of stuttering were based entirely on environmental causes, why would different environments not produce different results? Do high-income parents in the United States raise more (or fewer) stutterers than working poor parents? Do rural residents produce more stutterers than urban parents? Church-going versus non-believers? Jews versus Baptists? As far as I know, the answer to all these questions is no.
Stuttering has a long history of being the square peg that is pounded into the latest and most fashionable round hole. The rise of Freudian psychology made stuttering the result of a neurosis. Learning theory made stuttering the result of classical, and then operant conditioning. In each case, true believers of new schools of psychology looked at human behavior - including stuttering - through the tinted lenses of of their belief. In a sense, each school of psychology is an ideology. That is, they follow the logic of a single idea. The more aspects of the human condition that can be explained by the theory, the grander it becomes. In many, if not all cases, those taken by the logic of a particular psychological idea seem to have staked a claim to stuttering as their own, without first testing whether their theory was consistant with the knows observations of the condition. If they had done so, decades of wasted effort could have been saved.
Knowing that across cultures, social conditions, place and time, one percent of children become persistent stutterers, it is inconceivable to me that the cause of stuttering could be found in something as variable as parental - or child's own - attitudes. As phrased above, it just doesn't pass the sniff test. In science - indeed, in rational thought - we accept that which is provisionally most likely, and reject what which runs afoul of what we hold certain. With stuttering, this fundamental principle has not been followed. Favored theories have been proposed in sequence, without regard to what are sometimes called "the facts on the ground." Entire careers - and the careers of student/followers - have been built on foundations fatally flawed. The fact that so few people have pointed out these obvious flaws is an indictment of the field as a whole.
Sunday, March 7, 2010
Here's a little test for you. Fill in the blank at the beginning of each sentence. Don't take too long - just come up with something that seems to fit the definition. The result will not count towards your final grade. ;-)
1. ____ is a morbidity of social consciousness, a hypersensitivity of social attitude, a pathological response. 2. ____is the result of conflict between opposed urges to speak and to hold back from speaking. 3. ____ is the disorganization of normally fluent speech that is a consequence of conditioned emotion. 4. ____ is a symptom of an emotionally disturbed personality that profoundly affects the physical, mental and emotional life. 5. ____ is a habit of making elaborate preparations for speech on the assumption that it is a difficult and treacherous process. 6. ____ is an anticipatory, apprehensive, hyptertonic avoidance reaction. 7. ____ is a psycho-neurosis caused by persistence into later life of early pregenital oral nursing, with oral-sadistic and anal-sadistic components. 8. ____ is to speak or say with involuntary pauses, spasms and repetition of sounds and syllables.
Did you guess that the answer to the first definition was stuttering? How about the second? The third? Yep, the answer to all eight definitions is stuttering. The first seven definitions were taken from the following experts in stuttering by Marcel Wingate in his book Foundations of Stuttering: J.H. Fletcher, 1958, J.G. Sheehan, 1953, E. Bruten & G. Shoemaker, 1967, M. Gifford, 1958, O. Bloodstein, 1984, W. Johnson, 1948, I. Coriat, 1958.
The final definition was taken from Webster's New World Dictionary. Now go back and look at those seven definitions generated by "experts" and compare it to the dictionary definition. Doesn't the general-use dictionary make more sense than the expert definitions? Of the expert definitions, one, four, five and six don't even mention speech! Wouldn't you think that a definition of stuttering would at least mention speech, if not, you know, stuttered speech? Numbers two, three and five could refer to any anxiety over speech, such as stage fright. When Marcel Wingate gave this test to his speech pathology class, very few were able to come up with correct answers.
The truth is that these "definitions" excepting the plain-English dictionary offering - are actually efforts to rationalize certain theories of stuttering. All of them are psychological in nature. Some are still popular today. If I could do one thing for stuttering therapy education, I'd make every young prospective therapist get the final, dictionary definition tattooed somewhere on their body. Just so they don't forget, stuttering is stuttering.
Friday, March 5, 2010
Tuesday, March 2, 2010
Charles Van Riper was probably the most important stuttering therapist of the twentieth century in the United States. His methods have been adopted widely, and his books and other writing were highly influential. A recording of an interview he once gave is available here linked to the words "this interview."
"...these therapists who suggest that stutterers be willing to stutter.... I think that's outrageous. It asks the impossible. On the other hand, you can ask them to study what they're doing, to learn how to change what they're doing, and to find an easier way to respond to the fear of stuttering or to the feel of stuttering. If, when fear comes, he doesn't just panic, but he tackles that word carefully, if a moment of stuttering comes, he finds an easier way out of it, making faces, all of the unnecessary things that he's learned... you can be willing to work, but you can't be willing to stutter, I think. [my emphasis in bold]
Van Riper saw stuttering as an affliction to be confronted and overcome. I find it interesting that some speech therapists today use Van Riper's techniques, which are based on Van Riper's understanding of stuttering, yet seem to be more interested in the confronting and "accepting" than in overcoming.