About the authors: Susannah Parkin:  My name is Susannah Parkin. I’m a person who stutters and a first-year clinical psychology PhD student at Idaho State University. I’m originally from Boston, MA and I received my bachelor’s degree from Hamilton College in Clinton, NY in 2013. For the past few years, I have been working as the program coordinator at the Depression Clinical and Research Program at Massachusetts General Hospital. I interned at the Stuttering Foundation in 2011 and was interviewed on Episode 400 (Public Speaking, Stuttering and Doing What You Fear) of the StutterTalk Podcast.

About the authors: Karissa Colbrunn: I’m beginning my second and final year in the Speech-Language Pathology Master’s Program at Idaho State University. I’m originally from Southern California. I received a Bachelor’s degree from San Diego State University in 2015 with a major in Speech, Language, and Hearing Sciences and a minor in Psychology. I love spending time outdoors, especially near the water, and exploring new places with open-minded and curious people. I have recently become extremely passionate about how an acceptance approach can be taken in speech therapy when treating individuals who stutter, especially in an intensive setting. I’m also interested in raising stuttering awareness and knowledge, both generally in the world and specifically within the field of speech-language pathology.

About the authors: Tanner Saxton: Hello! My name is Tanner Saxton and I am a second year Master’s student in the Counseling Program at Idaho State University (ISU). I was raised on a farm just outside Paris, Idaho. In 2015, I completed a Bachelor’s of Arts degree in Anthropology at ISU and the following fall I entered graduate school, declaring as a school counseling major. I have many areas of interests within counseling that include trauma work, cultural counseling, career counseling, and addictions. As I prepare to enter my final months of the program, I look forward to working as a school counselor in a secondary education setting and to continue my career in coaching as well.

Our clinic experience this summer underscored to us the importance of this year’s ISAD conference theme, Stuttering Pride: Respect. Dignity. Recognition. We approached stuttering from a strengths-based perspective while simultaneously leaning into the challenges, fears, and anxieties that come along with stuttering. Paired with an emphasis on forward flowing speech and stuttering well, this holistic approach allowed us to move beyond acceptance into a stuttering pride and advocacy perspective. In our discussions and activities, we explored and experienced the power of having pride in the entire person, confidently talking about stuttering with friends and strangers alike, and maintaining our own dignity regardless of listener reactions.

How to Stand on Elephants

Susannah

This summer I participated in the Northwest Center for Fluency Disorders Interprofessional Intensive Stuttering Clinic (NWCFD-IISC) at Idaho State University. A collaboration between the Departments of Communication Sciences and Disorders and Counseling, it is the first and only clinic of its kind to simultaneously target overt stuttering and the covert emotional and cognitive processes associated with stuttering. The clinic takes an individualized approach in which each client is assigned one Speech-Language Pathology (SLP) Graduate Student and one Counseling Graduate Student to work with them as a collaborative three-member team (client, SLP, counselor) throughout the two-week clinic. The clinic uses an Acceptance and Commitment Therapy (ACT) framework to promote a positive self-perception and includes individual and group therapy, generalization activities in the community, and a high ropes course. Below you will find a description of the clinic experience from three distinct but interrelated perspectives: my own, my SLP, and my counselor.

At the beginning of the clinic, I described my stuttering as an elephant. It was a big presence in my life and my relationship with it was complicated. Sometimes my stuttering was an elephant standing next to me – it was always there and on my mind, but I could live in peace with it. Other times, I was standing on top of the elephant embracing the gifts that stuttering brought me such as empathy, perseverance, courage, and an ability to connect with others. And other times, the elephant was standing on top of me. It was heavy and suffocating and it stopped me from doing what I wanted to do. I vacillated between these frameworks and I spent more time than I wanted feeling paralyzed under the weight of the elephant not knowing how to stand back up.

My overt speech reflected the insecurity that I felt. I repeated phrases and used filler words because I wanted to avoid or at least postpone the moment of stuttering. I was afraid of stuttering because it made me feel helpless about my ability to say what I wanted to say. Even though I was moving forward in my life, I lived in fear that the elephant would suffocate me. As a result, I inhibited my words. I weighed the importance of what I wanted to say with the understanding that I would probably say it with a stutter – I held myself back.

Past mixed experiences with speech therapy made me somewhat wary of participating in this intensive clinic. I was afraid that I would be able to apply the speech techniques in the clinic room, but not in my real life and that I would blame myself for my failings, leaving the clinic feeling worse than I did at the beginning. The difference that this clinic brought to me, though, was that it changed my perspective on how I view situations and so-called “failures.” Stuttering is not a failure. Struggling to apply speech techniques is not a failure. Secondary behaviors are not failures. Someone interrupting you or hanging up on you or laughing at you are not failures. They are moments to be mindful and have self-compassion and keep going. They are learning experiences.

The connection and collaboration I felt with my team in addition to the positive environment promoted by the clinic as a whole facilitated my shift in perspective during the two-week period as well as in the time since the clinic has ended. My team made me feel accepted and empowered while simultaneously pushing me to my growth edge. I talked to them about my fears and struggles and with their support, I felt safe approaching challenging situations. We took each interaction as a learning experience and we debriefed about what took place.

As the clinic went on, I began to feel free. I started to break my habits of phrase repetition and using filler words. I experienced less fear when I spoke and said what I wanted to say without avoiding. I let go of my tendency to focus on what the listener might be thinking. I self-advocated and I talked about stuttering confidently and without apologizing. Now that the clinic is over and I am facing the new challenges of graduate school, I know that my journey with stuttering is far from finished. However, I also know that I have a solid foundation from which to move forward.

My clinic experience is not about fluency. It is about communication. It is about forward flowing speech and stuttering well. It is about accepting myself as a whole person just the way I am. Through this clinic, I learned how to stand on top of my stuttering elephant through realizing that my words are worth saying, I am important, and I am enough.

Karissa

Prior to beginning the IISC, I was extremely nervous but excited about treating stuttering. I found that my biggest tool at the IISC was not knowledge of speech techniques, but teamwork. I was worried after initially meeting Susannah and hearing about her negative experiences with fluency shaping that I was going to be the bad guy and wagging my finger telling her to use her techniques, but our team worked cohesively as a unit to address overt, covert, and secondary behaviors related to stuttering.  Susannah was so motivated and determined throughout the clinic and made my job as an SLP such an enjoyable experience.

I learned so many things from this immersive experience, three of which stand out in this reflection. 1) Think of your client as a member of your team, and treat them as the expert regarding their communication. I would not have gained as much valuable insight regarding Susannah’s treatment if we wouldn’t have taken the time to explore, process, and debrief following speech activities. 2) Keep an overall goal in mind and explain how tasks are feeding into this goal throughout treatment. My initial goal as an SLP was to teach Susannah how to use techniques so she could use these on her own. This later shifted into using techniques as a way to self-advocate and approach situations confidently and encourage my client to say what she wants to say in all situations and not be held back by her stuttering. I made an effort throughout the clinic to explain how each task led into our overall goal. 3) Enjoy the journey while working toward a goal! The process is just as important as reaching goals, and I would have missed out on once-in-a-lifetime experiences if I would have been entirely focused on accuracy percentages and techniques during the clinic.

Tanner

For me, this was a journey of risk-taking, self-discovery, team cohesion, and of course, an increased understanding and awareness of stuttering. To say that stuttering is EXTREMELY challenging in terms of emotional, mental and spiritual stamina is an understatement. I never could have prepared for where this journey would take me as an emerging counselor. The trust that our team was able to build throughout the process was vital to our work and served as motivation for us to work together in the face of so many unforeseen (at least to me) obstacles. Each of us was committed to the process and brought with us unique perspectives as professionals and as people.  Susannah was the expert on herself as a person who stutters; she could describe her stutter in both a beautiful and profound way; yet to an outsider of stuttering like myself-my conceptualization of the elephant was lacking.  My conceptualization was that it was the one in the room that I wasn’t clear about how to talk about. We became empowered together to converse about and explore stuttering. For me, the entire clinical experience was a reflection of Susannah standing on that elephant and I was lucky enough to ride alongside.

One of the things I loved most about this experience was the way in which we were able to collaboratively investigate covert aspects of stuttering and apply creative approaches to our exploration. We used play therapy, music therapy, art therapy, talk therapy, recreational therapy and brought in various metaphors and applications of these mediums to help us understand more about the individual experience of stuttering. I even had to pseudo-stutter in public as well as use techniques throughout the clinical experience which in and of itself was a way for us to gain some common ground. Although it was a far cry from understanding what it’s like to live with a stutter, I certainly gained more empathy in these experiments. I found that the wide-range of activities and approaches allowed for creativity in therapy in a way that maximized our growth as a working unit and that led to incredible insight.

Throughout the therapeutic experience, we each held space for moments of self-awareness and growth and it was both exceedingly exhausting and deeply rewarding to me! I developed a more acute sense of the lifelong challenges of stuttering; it’s hard!  The strengths of the individual were of such a profound nature that building on these was intrinsically related to the presenting challenge of stuttering itself. Resiliency, empathy, courage, intelligence, selflessness, and many other qualities struck me as being reflective of the belief that the PERSON truly comes first; the person comes before the stutter. The success that I believed we had as a team came from a willing client, one who “leaned into discomfort” and one who shared her experience freely and openly. I am grateful to have embarked on such a unique inter-professional experience, one in which I never would have thought I’d be riding elephants in Idaho.

Susannah

As a person who stutters, I have the opportunity to expose my greatest vulnerability every time I speak. Revealing myself in this way is scary because I don’t have control over how others react. And people do not always react well to stuttering – they may express discomfort or mock or turn away. Anticipating and dealing with listener reactions has been one of my greatest challenges because I’ve always felt like those reactions said something about me and my worth. However, through the collaboration and trust that I developed with my team during this clinic, I have begun to realize that I and I alone have the power to define my worth. By leaning into my fears, I’ve experienced the incredible power that comes with being vulnerable. I’ve also learned that by stuttering well with openness and confidence, I can communicate my self-worth to others, perhaps showing them that they have the power to do the same.