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How to change stuttering from “no sound”(silent blocks) to audible(repetition and prolongations)? — 10 Comments

  1. Hi Ari – always nice to see you on these forums. You’ve asked another great question. First, I’d say that the goal of changing the form of stuttering (e.g., from blocks to repetitions) is very helpful for many people. Sometimes just trying to change the stutter (rather than trying to prevent the stutter) can help that ‘stuck’ feeling to diminish.

    Second, though, I want to acknowledge that this can be very hard to do. There are a couple of reasons for this – one is that the stuttering pattern (that is the way a person tends to stutter) can be highly automatized — the tension or eye block or pushing is so much a part of the person’s stutter that it can be hard to separate that surface behavior from that internal feeling of stuttering. Another is that pushing or tensing is essentially a normal reaction to feeling stuck. In nearly every other situation where one feels stuck, pushing can help.

    For example, when your car door is frozen in the winter, what do you do to open it? You pull (tense) harder to get it to open. When the combination lock on your shed door is stuck, you pull harder. When the lid to the jar of pickles is overtightened, you tense up more to force it open. Etc… In nearly all of these other cases, tensing can help (though if the lock on the shed is broken, you need a hacksaw ;-).

    My point in bringing these examples is to say that tensing is not abnormal – it is perfectly understandable and nothing to feel bad about. When speech-language pathologists encourage you to tense less (an admirable goal), we are essentially asking you to do something that is counterintuitive and contrary to other experiences in your life.

    Alright, enough on background. Now, what to do about it? There is no magic answer, I’m afraid, but you knew that was coming… Many of my clients have found that trying to start their phrase with a different type of stutter, for example, an easy repetition (a la the “Iowa Bounce”) can help them get their articulators moving so that they can get into the stutter and then modify it using other strategies as they like. Another example is an easy prolongations (Sheehan’s version of voluntary stuttering) that they stretch into and then modify.

    The key to this idea is that one is not trying to be fluent when starting out – one is instead trying to stutter. It is that acceptance of the stutter that seems to help. I mention this because you said that you feel anxious to get the sound out – absolutely understandable, but it does reflect the desire to get started as quickly as possible. If instead the goal is to start out more slowly, to wait out the stutter for as long as it takes, to allow the stutter to happen in its own sweet time, to (as one of my clients put it) savor that moment of stuttering, then the desire to rush, to tense, to hide, to avoid can be diminished.

    Again, it’s not magic, but it is another example of where voluntary stuttering or pseudo stuttering (fake stuttering) can be useful – and it highlights the importance of desensitization. If one can focus specifically on that desire to rush through a stutter or the impatience about wanting a stutter to end, then that extra tensing can be reduced… For example, my clients might practice doing a pseudo stutter that lasts longer than the duration of their typical stutters…when they have desensitized to that, then they can better tolerate the real stutters. This might mean waiting a long time – if a person’s typical blocks are 10 seconds in duration, then s/he needs to be able to tolerate an 11 second block – we practice that in therapy and in the community. If a person’s blocks are generally just a second (and I say “just” only in the relative sense — a 1 second block can still seem like an eternity), then s/he needs to be able to tolerate a 2 second block (twice eternity!)

    When the desire to hurry subsides, then it can be easier to start off with less physical tension. And, this buys more time for any other modifications. It is hard work, but the desensitization and willingness to try stuttering differently can pay off in easier stuttering and less anxiety.

    Of course, all of this would need to be adapted to each speaker’s individual needs and preferences, but perhaps there are some ideas here that might be of value to you. Thanks again for your post and for the opportunity to share my thoughts.

    Scott
    —-
    J Scott Yaruss, PhD, CCC-SLP BCS-F, F-ASHA
    University of Pittsburgh, PA
    http://www.Yaruss.com

  2. Dear Ari, thanks for Your questions!
    I just want to share with you some of my experiences related to silent blocks. Maybe very much information can be added to the concept “make the Stuttering audible”. One way of making this concept real might be to modify the blocks by using low frequency and low amplitudinal vibration of the vocal cords -while airflow is moving more slowly. Anyhow, the reason for responding is because I want to tell you that there is several ways to use the technique “pull-out”, which is the opposite of pushing with extra tension. The main point is to reduce the tension (while you are in the middle of a Block) and finish the word with a more relaxed speech production. As Scott Yaruss is highlighting, everything has to be adapted into each speaker’s individual preferences, and I have limited information about you and your speech/Stuttering. Instead of transforming your Speech from one Stuttering event (silent Block) into another Stuttering event (repetitions), I sometimes experimenting With using the pullout in a more directly way; to release the Block by using the airflow more actively/conscious. It is hard to explain and I know that this exercise is hard to catch without me or another SLP to demonstrate it. Often this pullout, which is defined as a Stuttering modification strategy, can be combined with other Speech adjustments. I am not sure if this information helps. The response from me is also limited to Speech Production, in regard to the integrated or holistic perspective, which is the framework I am working within.

  3. Dear Ari,

    Such great responses by Scott and Hilda, such that there is very little that I can add. From what I’ve read, it sounds like you’re aiming yourself in a good direction. In transitioning a (stuttered loss of control) into audible stuttering, you’re creating a platform in which to work and change. I’ll suggest to my students and our clients that the failure to initiate the gesture is at the overt behavioral core of what stuttering is; and what we do with that failure to initiate is often a series of (unconscious and conscious) reactions and responses that turn into habits. (This is a gross oversimplification, but it seems to hold some value at least.) The hierarchy that I generally start with for cases such as yours is: (a) Begin addressing the ability to “stay in the moment” of stuttering both consciously and deliberately. Without the ability to consciously and deliberately respond to these failures of speech initiation, stuttering controls us (and not us—it!). There are many creative ways to help toward this goal—perhaps a topic for another day. Then on to (b) which is the deliberate use of volitional stuttering to foster voicing (audible stuttering). Personal experience, and that with my clients, have found that volitional stuttering is a terrific tool to establish a forward flow of speech, while creating new and better speaking habits. Hope this helps,

    Greg Snyder, PhD CCC-SLP
    Associate Professor
    The Wheat Laboratory for the Voice, Speech, and Hearing Sciences
    Department of Communication Sciences & Disorders
    George Hall, Office 310
    P.O. Box 1848
    University, Mississippi
    38677-1848

    GoogleVoice  662.259.0123  /  Office: 662.915.1202  /  Fax: 662.915.5717
    GSnyder@OleMiss.edu / Greg.Snyder@SpeechandHearingCenter.org

  4. Hi Ari,
    I know it seems like there are some sounds that are hard to say, but it is really the thinking about them before you say them and the trying to get them out that makes them hard to say and makes the speech system blocked. The less you focus on the sounds, the easier it will be in general to talk.

    It’s really much like a snowball. The problem starts off from it’s essence and the more you anticipate the sounds and words, the harder it is to talk and the more anxiety you feel. This anxiety makes you anticipate and try more. And so the snowball grows.

    The best way to melt the snowball, is to think less about talking. When you’re alone, you probably don’t experience as many blocks, if any. Ask yourself why. Are you anxious about getting the words? Are you trying to talk. Notice how little you do to speak. Next ask yourself what it would be like to become oblivious of the words and sounds that you are going to say even if you are in a dialogue. Maybe even experiment with doing this. Notice the feeling of not knowing. Is it fearful? fun? ???? I suggest that you play around with this and let us know what you experience.

  5. Scott ,one the reasons I ask those questions is that I hope to receive such wonderful answers like yours.You wrote it so good,and I learned from it a lot.
    Hilda:Thanks for your reply like you wrote it is difficult to explain it on paper,so I am not quite sure what you meant and I am curious about it .
    Barbara: thanks for your reply. I understand what you want to offer. But I found that to run from stuttering doesn’t help me,but to face my stuttering and change it.
    Greg( a lot of time i dont bother you) thanks for your reply. I always glad to read your advices and thoughts(and of course i will glad to read about how to “stay in the moment of stuttering” ).
    Ari
    geashono@gmail.com

    • Hi Ari,
      I am wondering what I said that gave you the impression that I advocate running from stuttering. Maybe it is that I advocate changing the way you focus and think when speaking. Of course that will change the stuttering. You said that you want to face the stuttering and change it. I was only suggesting a way to change it, not to hide it.

  6. Barbara,when you focus is on fluency.You will do everything in order not to stutter(including changing words,avoiding and more).
    This is true in Fluency Shaping and other fluency methods like yours.
    For some people it quite help.But I personally need to find the way, how to stutter differently when i need to stutter and all those methods dont solve this problem(and dont reduce the fear to stutter).
    Ari
    geashono@gmail.com

    • Hi Ari,
      I full agree with you that focus on fluency is not helpful. That is why that is not part of the therapy I do with clients. I did do fluency shaping 30 years ago, but that is not the way I treat stuttering now and has not been for many many years. I also don’t teach people to stutter differently. That is still putting the focus on the problem. I teach people to speak differently, easily and comfortably. You are so right that reducing the fear of speaking is so important. After all, the goal of therapy should be to enjoy speaking. At least that is what I believe.

  7. Ari,

    Hello.

    For some time I’ve been writing about the need to learn to work skillfully with the fear of stuttering to speak with greater ease. This is what I have found personally to be absolutely critical to experiencing satisfaction and, even, enjoyment speaking. And I think you recognize, too, that learning to manage the fear that comes into play when speaking or anticipating speaking is a very necessary skill to speak more as you would wish.

    I’ve written about dealing with my fear of stuttering and how I’ve learned to manage it in two books – “Mindfulness & Stuttering. Using Eastern Strategies to Speak with Greater Ease” and “Relief From Stuttering. Laying the Groundwork to Speak with Greater Ease.” Using the mindfulness meditation technique called “shenpa,” which loosely translates as fear, that I found helpful may not appeal to you. I don’t know whether or not it might because I don’t know you, but it’s “out there” and has been for about 2,500 years or so! It may help you or it may not. I’m mentioning it as something to consider.

    Working with shenpa builds on the ability to use mindfulness meditation techniques, such as “shamatha-vipassana,” to first calm and then focus the mind, which I wrote about in “Mindfulness & Stuttering.” My personal fears about stuttering were that it would strangle me to death (I had laryngeal blocks; some of which began silently) and that it would cause me to be excluded from relationships and make me an outcast.

    By working on acknowledging my fears, refusing to run from them, and ultimately to “lean into” them as a middle-aged adult helped me live and speak with greater ease and satisfaction.

    The book “Smile at Fear” by Chogyam Trungpa and the CD set of a workshop given by one of his best known students, Pema Chodron, also called “Smile at Fear,” may be of interest to you.
    They are available on amazon.

    I wish you the best as you search for what will be helpful to you personally.