Automatic speech as part of communication
Hello Experts,
Barbara Dahm gave a very interesting video entitled ‘Making Therapy a Successful Experience’.
I interpreted her video to say that speaking should be automatic, but that we who stutter spend more time in our conscious mind preparing and thinking about our words. Also, with therapy we learn ways to reduce blocks in number and intensity etc. Again use of conscious mind to produce sounds and words.
I know that my goal is better communication day by day. I love just opening my mouth and talking without any consideration of stuttering or fluency. This fits in with Barbara’s idea that I am letting language / voice / mouth happen automatically.
My understanding of our bodies automatic processes (breathing, walking etc) are that these happen in our unconscious minds. I believe that repetition of actions can change our ‘programming’ so that we can use our unconscious minds more, if we choose to do so. This leads me to the conclusion that we PWS can retrain ourselves to relearn use of automatic production of language / voice / mouth.
We could say that as regards speaking, PWS are like anyone learning to drive a car. Everything is done with the conscious mind and takes so much time and effort. But the more it is done and experience gained action after action is taken over by our unconscious mind so our conscious mind is less involved in many aspects of driving a car.
Humans communicate using both the conscious and unconscious parts of the mind. PWS need to learn to use the unconscious part much more.
Do you agree with any / all of the above? What are your thoughts about this? Should therapy be amended to include finding ways to get onto automatic language production?
I hope you all have a very good conference.
Keith Boss
Hello Vivian,
Thank you very much for your time to read and reply.
I am sure there is a need with many clients to teach control tools that they can be comfortable using outside the clinicians environment. To me the main benefit of this is to build up positive memories of speaking to begin to use as affirmations and reduce the impact of the stored negative memories.
Also there is a need for the clinician to assist clients to evaluate their thoughts about many aspects of speaking / communication and socializing to begin to address the myriad of negative feelings and increase desensitization.
Then, and possible only then, the therapy might change to working towards spontaneous communication.
I have achieved progress myself along the lines in various aspects of communication. One situation still needs a lot of work. Interactive conversations. I have no anxieties and have no stress, but I am still using my conscious mind far to much. It is proving to be an effective barrier to spontaneous replies and repartee.
Enjoy the next three weeks,
Keith
Hello Keith,
Great topic! For me, it also brings to mind the notion that control may interfere with forward moving speech. I agree that we need to aim for spontaneous communication for the benefit of long term change. Efforts to control are efforts at suppression, whether the objective is fluency (reduced frequency) or easy stuttering (modification). That said, sometimes some work needs to be done to facilitate the goal of spontaneity. If a PWS is using struggle or escape behaviors that interfere with forward moving speech, he or she would benefit from first doing some concentrated work to eliminate them. Some of those behaviors may include adding sounds or words (fillers), repeating words already said, or starting an intended word with a tongue/jaw/mouth movement that is not part of the intended word. Work to reduce these behaviors can pave the path for spontaneous, comfortable speech as long as fear/shame related to stuttering are simultaneously desensitized.
Vivian
Keith,
Thank you for taking the time to ask a question. You bring up a good point, ” Should therapy be amended to include finding ways to get onto automatic language production?”
Let me ask you a question. I will make the assumption that you are like most people who stutter… You are a Person Who Stutters Sometimes. That is, some of the time, maybe the majority of the time (if you consider % of syllables spoken) you don’t stutter. You just talk… automatically… naturally.
If this is the case… do you need to LEARN how to speak automatically in therapy, or do you just need to learn how to do more of what you are already doing that is working? And possibly figuring out what is getting in the way of you doing this at other times?
I’m interested in your thoughts.
Kevin Eldridge
Hi Kevin,
Thank you for taking the time to reply to my questions.
I stuttered for 65+ years. I had a powerful reason (in my own mind) to eliminate / improve my speaking in 2005. In 2006 I searched on the Internet; bought a few books; joined online groups; joined the Boards of the BSA (UK) and ISA thus exposing me for the first time to others PWS. Currently as Chair of the ISA one of the things I am working on, with others (ISA and IFA), is to try to find ways to increase the value of therapists to PWS. (Another is to increase the number of therapists in parts of the world where there are not enough.).
One of my journeys since 2006 was to study how our minds work. Hearing Barbara’s video made me connect up the dots, based on my own experiences and hearing other PWS experiences, in my own way. This may not be the best way, hence my asking about it.
Pre 2006, I planned most sentences ahead. I rehearsed and rearranged words. Most times I stuttered, in every sentence. My layman’s analysis of those years is that most of the time I was using my conscious mind —– because I did not know any better and I was not opening my mouth and talking automatically…naturally.
Currently I never ever have uncontrolled negative feelings / thoughts, because when they occur I examine them, learn what lessons I can and then reverse or eliminate them. So all the pre 2006 emotional baggage I had is gone. Even though in monologues my communication is getting to be very good, in conversation there is room for improvement (I visualize communication, not stuttering, because I do not want the battle between my conscious mind not wanting to stutter and subconscious mind trying to make it happen.)
Your clinical technique of asking me a question, to help me to work out the answer for myself would be superb if I was just asking for myself. But I am asking for others. Barbara’s video is the first time I have heard a clinician talk like this. It meshes with recent learning I have done. I am asking the experts about this. I know that this would be new to me if I had not studied how my mind works. I assume it will be new to many PWS. I would be really interested in your thoughts on if this is work that therapists should undertake towards the end of their therapy with most clients.
My question should be rephrased. ‘Should therapy be amended to include improving ways to get onto automatic language production?’. You could reply that that is what you do. My response would be I never knew that as i have never seen it discussed, until now.
Enjoy the conference, it is rewarding to many of us in the stuttering community,
Keith
Keith,
I think you bring up a very important point.
As I mentioned in my earlier post, most of the PWS I know are more accurately People Who Stutter Sometimes (a term I picked up from Kristin Chmela). The time we are not stuttering, we are often, “just talking”. So… to answer your question. Yes, I believe that therapy should focus on natural speech or as you term it “automatic language production.” But I believe that we (as SLPs) don’t really need to teach anything new. In most cases, we can help the PWS to better understand what they are doing when they are “just talking” and then help them do more of that. In my mind, this a significant departure from what most of us were taught in school – and continue to be taught in many continuing education seminars.
I hope you continue to enjoy the conference… I am.
Kevin
Kevin,
Again, thanks for replying.
I know it is difficult to pin down a perfect definition of stuttering. I would assume that if I am planning my words ahead (conscious mind) and word rearranging (conscious mind) then I am stuttering, even though I appear to have a miniscule % of stuttered words/syllables. A covert stutterer does this well. Looking at my stutter from this point of view I stuttered always, not sometimes. This is stuttering from my point of view and my journey to where I reached at the end of 2005. With hindsight, there was one consistent speaking situation where I did little to no planning ahead. Whispering sweet nothings to my late wife. During those speaking times I was often whispering (so I may have been on my ‘lateral’ speaking path where I will not stutter—— see research by Per Alm) and I was speaking with no planning of words in my mind..
Post 2006 I have formed the view that there are two tasks for therapists to complete in order to help PWS.
1. Offer tools to help us to reduce the tension when we speak / speak more fluently / stutter more easily —- there are many ways to express this and
2. Help us to explore and resolve our poor or negative emotions and feelings (the part of the iceberg below the surface).
Since the beginning of this conference I am thinking that there may be a third task. Using the analogy of the different uses of our minds when learning to drive and when we are an experienced driver,
3. help PWS to realise that the tools we learn in task 1 are just a crutch and a time will come when they should be discarded.
Whenever we leave hospital with a crutch we lean on it the whole time to start with, Then we slowly reduce our use of it until we no longer need it. So with our therapists tools. PWS should use them the whole time, at first, and slowly over time reduce their use until we carry them around in the tool box to pick out as and when we need them. A time will come when we go out and leave the tool box behind. That is when our speaking becomes natural with no advance planning of words or fluency shaping or block modification or easy onset ….
Good to explore this with you,
Keith
Keith,
I too am enjoying exploring this with you.
So the first question is when you are planning ahead and rearranging words (conscious mind) are you stuttering. As you inferred, this is a matter of semantics, but I say no. You are not stuttering. You may be thinking like a person who stutters, or doing things to “not stutter” – both of which are not using natural speech, but I would say not stuttering.
I’ll need to look at Per’s work again (I have his dissertation on my computer – that is how much I like his work 🙂 but I thought the lateral path he spoke of was for automatic speech, singing, etc…. not whispering loving thoughts to your wife. Maybe you do stutter all the time… maybe not.
I used to be a big fan of fluency modification tools. No more. But our thoughts are close.
I work on 1) doing more of what is working and 2) exploring what is below the surface of the iceberg. In fact… I think this is really where the most work needs to be done.
I’m sitting on my back porch drinking a cold beer after finishing painting my garage. Having this discussion with you (with a cold beer at my side) is a great way to relax after a long day in the garage 🙂
Kevin,
The first para. of yours concludes I am not stuttering under the circumstances you mentioned. (thinking like a PWS and doing things not to stutter like an experienced covert PWS). Did you really mean this? I feel certain you would not use this as a yardstick to measure a successful outcome for a client. So if it is not a suitable yardstick, a definition of stuttering that only looks at ‘a % words/ syllables/ sounds of non fluency’ is flawed. More therapists like yourself look at the hidden part of the human Iceberg but I think the process gets muddied when there is lack of clarity in answering ‘What is stuttering?’ or ‘Are covert stutterers stuttering when they hide the stutter for a variety of reasons?’. You appear to say no, I say yes. This just highlights two different versions of reality.
One of the reasons I prefer my version is that when I am thinking as a PWS and acting as a covert PWS my conscious mind is visualising stuttering and looking for ways to avoid what is being visualised. Unfortunately my subconscious sees this visualisation and tries to make stuttering happen. Conscious and subconscious are at war with two opposed objectives. This is not good, as you will know. I stopped thinking as a PWS and trying to act as a covert PWS in 2006. I do not plan words ahead now, and I am slowly increasing aspects of my communication when I am in a natural flow. Still lots of work to do, but my communication (words / body language / tone ) is improving day by day. Also when I am not successful, e.g. in a specific phone call, I will recall / examine / analyse and then move on with a lesson learned and no recrimination.
I first met Per in 2006 in the UK. My interpretation (maybe distortion) of what he said was that if speaking in your non-usual speaking voice you were no longer on the medial path, but on the lateral path. Usually the lateral path (automatic speech) had an external ‘prompt’. e.g. singing / acting a part / reading or speaking in chorus etc. Maybe whispering has no external ‘prompt’, but it was not my usual stammering speaking voice.
I like your approach 1. Looking at what works and seeking more of it is superb. This mirrors David Shapiro’s technique of building towards a client monitoring his/her speech and counting the times a difficult word is said without a problem. Focusing on the positive.
As regards your approach 2. Again, superb. I look towards the time when all therapists in the world are confident enough to undertake this with all clients who have any communication problem.
I had three days of interruption during my response to you — one of the interruptions was getting closer to being invited into a local prison to talk to inmates and guards about all issues relating to stammering. One of the Governors at the prison has time this week and says she wants to talk.
I visit with my daughter’s family in Peoria (Illinois) twice or more a year from the UK. Would you like to meet to have a chat? Shall we arrange this offline?
Thanks for your active participation in this conference,
Keith
Keith, thank you for bringing up the topic of automatic speech production so that we can all delve into it in more depth. I think that you as a PWS who has developed so much inner awareness since 2006 really understands what I’m trying to say. After reading the thread, I do want to make a few points. I agree with Vivian when says “Efforts to control are efforts at suppression..” and it does interfere with the forward flow of speech. However, the interference is deeper. Thinking about words affects the motor programming of speech production. It affects the breathing, phonation, articulation and can cause body and facial tension. So I think that all of the work SLP’s do with desensitization and changing thoughts and perspective is essential and can be very helpful in getting to speak on the automatic mode. However, I don’t agree that we should teach control techniques first and then hope that in the end the person will get to speak automatically. I think that desensitization and reprogramming thoughts needs to support and be supported by seeing how to develop speech automatically. Concerning whether PWS have to learn how to speak automatically or not, I both agree and disagree with Kevin. Keith, I love what you said in your last post about stuttering covertly. I agree that we can’t say whether the process was automatic or not on the basis of hearing or not hearing stuttering. There can be so much “stuttering process” when you can’t perceive the stuttering. The listener might not be aware of it, but the speaker usually is. Granted s/he might have gotten so used to it that s/he doesn’t think it’s struggling, but speaking just isn’t comfortable. I do agree though that PWS do already have all the basic elements necessary and may be using them like everyone else on some occasions, such as the occasion you mentioned. So I agree with Kevin that we SLP’s can help our clients to see when and how they are processing speech automatically. It’s more becoming aware of the differences than learning a new skill.
Hello Barbara,
Thank you very much for your kind contribution. When I saw your video, i had one of the ‘a hah’ moments of life. Hearing from a therapist that I should be aiming at ‘processing speech automatically’ just complemented what I loved doing. Opening my mouth and talking.
One very good way of doing this, even though it may be a little daunting at first is the Toastmasters International club agenda item Table Topics. There is a Table Topics master who runs this agenda item. S/he prepares a list of topics in advance and in secret. S/he then calls on club members at random and gets them to come to the speaking area. The member is then given a Table Topic and has to talk for two minutes. No advance planning time at all. If you know the subject — fine; if you do not know the subject the task is tougher. All speaking is appraised by an appraiser and a constructive verbal and written report is given. UMMs / ERRs / and other filler words or expressions are counted by another member and your tally is noted. (I asked for a starter of 100 as I was a PWS. That was a nono!!!!!!). Your communication skills and humour are high in the appraisers minds. The content of the speech is less important, particularly if you deliver an entertaining speech.
The club purpose of this task is to give practice to members to hold their own in casual conversation at work engagements. For me, it gave me practice at processing speech automatically. I just planned ideas an let the speech flow.
It is very good to see so many PWS and therapists and trainees exchanging ideas so easily. Thank you for being one of the experts and for your own contributions to this conference.
Keith
I know of Toastmasters and have recommended it to many clients. Actually, I would do well to join myself. Your giving speeches without planning was I’m sure very helpful. The planning though can be much more subtle for some people. It could be trying to form words as you say them. Some people even report trying to see the word in their minds eye.