Emergence of stuttering: How and why?
Hello, everyone. My name is Kristen Kostecki and I am a graduate student aspiring to become an SLP. Being enrolled in a course about stuttering, I can’t help but find several questions about stuttering left unanswered. I wish I could personally experience what it is like to be a person who stutters (PWS) so that I may have more specific insight as to why and how it happens. On this site, I came across an individual’s post about how he did not start stuttering until age 8–after he received articulation therapy. According to what we generally study in my course, the population studied for stuttering usually falls between 2-7 years old because many cases can often lead to recovery. How can emergence of stuttering around 8 years old (and continuing into adulthood) be rationalized? We often discuss that stuttering in PWS can often be induced by emotional fluctuations or complexity of language, but what could cause someone who never stuttered to all of a sudden begin stuttering? I would hypothesize that some sort of traumatic event may trigger stuttering, but I do not know of any research that would support this. I would appreciate any insight that could be offered!
Stuttering caused by a traumatic event would be classified as a conversion reaction, as Oliver Bloodstein and I wrote in the last edition of the Handbook on Stuttering, and that disorder is virtually exclusively found in teen and older women, not exactly the profile of stuttering. I don’t know that we have much good data on stuttering emerging after trauma, although some is coming from injured vets (at least I have heard conference reports).
I share your thoughts on this type of report; my best speculation would be that articulation therapy made this individual more aware of his speech, which is what we typically need to do to improve articulation – most children with articulation errors seem rather oblivious to the mismatch between their productions and the target. Many therapists also over-articulate targets, which may have taught the child to hit places of articulation with particular strength, something we know is not exactly fluency-inducing. It’s hard to speculate, but perhaps this taught a counterproductive way of making articulation gestures, while at the same time heightening awareness of his speech – both could contribute to making fluency worse while making him more aware of any ongoing problems with fluency. But you’re right, and these cases have been reported since Van Riper. However, stuttering as a response to “trauma” is not the best hypothesis out there – it encourages parental feelings of guilt, without any documentation, and badly twists the available literature on any other behavioral responses to trauma that psychologists have been able to document. Nan Bernstein Ratner
The Tyranny of Shoulds and the Wish/Demand to not be Different
Dear Kristen,
I am a person who stutters who has recovered from stuttering and work as a coach on the internet to help others to recover from stuttering using Rational Emotive Behavior Therapy. I have a Psychology Doctorate and am licensed as a clinical psychologist.
While you may not be able to experience all aspects of how a person with a stutter feels, you may experience two of the most important aspects which were both instrumental in starting stuttering and especially in propagating stuttering.
Building on the psychologist Karen Horney, I was able to establish why so may PWS are so distraught and so stuck in therapy. In short, every person has an image of their ideal self. On the other hand, there is an actual self.
The PWS’s ideal self is someone who does not stutter and can easily articulate their thoughts and feelings. In other words, the ideal self is defined as, “If I know what I want to say, I should be able to say it effortlessly.” Most PWS have had instances when they felt at ease and were fluent even in circumstances when they normally experience disturbed feelings about speaking and have struggling, forced disfluencies.
On the other-hand day to day, their actual-self displays, both the dysfunctional underlying feelings and emotions of shame, guilt, etc. that can be classified as unhealthy negative emotions and their speech is quite disfluent containing many struggled, forced disfluencies.
The tyranny of the SHOULDS happens when the PWS defines his REAL self to be his ideal self. He demands that he be relaxed and flowing in his speech. He exclaims, “I should be my REAL self (meaning his IDEAL self)”. This is against reality. His real self is his actual self. Sometimes calmer, sometimes more flowing in his speech, but frequently under the spell of unhealthy negative emotions and having imperfect speech.
To experience the PWS feelings talk yourself into getting A+ on every test you take. Really demand it. And see what happens as you start to write an exam. If you are good in demanding you can really talk yourself into a dysfunctional state.
But perhaps the most pernicious feeling that a PWS has is the perceived need to be the same as everyone else. To see how hard it is to be different, resolve for a whole day to pseudo stutter in every situation or, better yet, put on half a face with one style of a make-up and the other side of the face with another kind of a makeup. I would not expect you to be able to wear the different makeups the whole day. Just do it to one class. Yes, it is very, very hard to not be normal, to be different. It takes a lot of persuasions to have a client understand that we are all individuals and all of us have some characteristics that make us different.
Gunars
Hi Kristen! I am also a graduate student in SLP! In my stuttering class and in our textbook, it has been discussed that traumatic events do not cause stuttering but may allow underlying factors that influence the onset of stuttering to rise to the surface. These traumatic events often serve as a memory marker for parents to identify as the cause of stuttering. In addition, stuttering may also occur when the individual becomes aware of his/her speech and stutters when trying to avoid a dysfluency. In the situation you addressed, the individual may have become increasingly aware of his speech through articulation intervention and started to stutter as a result. When it comes to the age of onset for this individual, most people who stutter begin stuttering by age 3.5 and the risk reduces as they age. While emergence of stuttering in older childhood is less likely, it is not impossible. Great questions! – Amber Hagen