 About the Author:
Jorie (Marjorie) Rosenthal Foer, M.A., CCC-SLP, BCS-SCF, is a speech-language pathologist who stuttered briefly in her twenties and experienced fear of speaking in groups of two or more for over four decades. She is one of the initial cadre of SLPs to become Board Recognized/Certified in Stuttering, Cluttering Fluency. In her private practice, StutteRevolution.com, she delights in helping people discover and identify with their Self Energy/Inner Wisdom and learn to trust their Innate Ability to Speak Naturally. |
I love this year’s ISAD theme, Shades of Stuttering—What’s Yours? People who stutter (PWS) have different histories, patterns of stuttering, beliefs, and ideas about what helps. As Michele Ayoub reminds us, “Every shade is valid.”
That includes techniques, acceptance, somewhere in between—and perhaps possibilities we have not yet fully explored.
As a speech-language pathologist (SLP), I was trained to listen to my clients and follow their lead. There is one shade of their experience that particularly interests me:
What can we learn from the times when a person who stutters speaks naturally?
The Shade We May Be Overlooking
I ask every PWS with whom I work whether there are circumstances in which they speak naturally, with ease and without thinking about their speech. So far, everyone has told me yes.
It may happen when speaking aloud alone, talking to a pet, baby or toy, or with particular people or in particular situations.
For decades, I have wondered why we don’t become more curious about these experiences.
More recently, Jackson and colleagues (2021) gave us a compelling reason to do so. They investigated the “talk-alone effect” by creating a private speech condition in which speech was intended only for oneself and speakers did not perceive that someone was listening.
Twenty-three adults who stutter produced 10,844 syllables during private speech. Only seven possible, mild stuttering events occurred across three participants. When participants produced the same words while addressing two listeners, stuttering returned.
Think about that.
The words did not become harder. The participants had the same speech mechanisms. What changed was the context and, critically, the perception of a listener.
Jackson and colleagues concluded that the perception of a listener, real or imagined, plays a critical and likely necessary role in stuttering events.
But what if speaking naturally wasn’t viewed as an exception to stuttering? What if instead we considered what it reveals about the person’s capacity—and what that might mean for our role as SLPs?
I call this capacity the Innate Ability to Speak Naturally (IASN)—an ability PWS recognize firsthand when their speech emerges naturally, spontaneously and without deliberate management. In those moments, they simply speak, much as a person who does not stutter speaks.
Recognizing their IASN invites PWS to notice, become familiar with, and increasingly identify with who they are when speaking feels natural, comfortable and authentic—because it is all of these!
I ask my clients to become curious about these natural speech moments: What does that feel like? What are you thinking about—or not thinking about? What happens in your body? Where is your attention?
They Already Know How to Speak
If a PWS can speak naturally when they do not perceive a listener, what exactly do we need to teach them about speaking?
Just like people who don’t stutter, when speaking naturally, PWS already coordinate respiration, phonation and articulation, vary pitch and loudness, use rhythm and prosody, and express their thoughts—all without consciously thinking about how to produce speech. Natural speaking is highly spontaneous. We just speak.
They already know how to speak. So why teach them how?
Teaching PWS to deliberately change articulation, rate, airflow, voicing, prosody or other speech parameters directs attention back to how they are speaking. But this is precisely what they are not doing during natural speech moments. When they have freer access to their IASN, they are not managing speech production. They are simply speaking.
Why teach greater attention to speech when PWS tell us their natural speech emerges when they aren’t paying attention to it?
Rather than teaching PWS how to produce speech they already know how to produce, I believe we should help them recognize and trust their IASN and become curious about what gets in the way of accessing it.
The question changes from How can I teach this person to speak differently? to:
What changes within this person when speaking naturally becomes less accessible?
Being Rather Than Doing
That shifts our attention from doing something to speech toward the person’s state of being while speaking.
When my clients describe natural speech moments, I hear qualities such as calm, presence, openness, confidence, playfulness, joy, curiosity about others, and the desire to connect. They are simply being themselves and communicating.
Constantino and colleagues’ (2020) research on spontaneity offers an interesting connection. They describe spontaneous speech as involving little premeditation, effortless production, enjoyment and meaning, with little or no attention directed toward physical speech production. This echoes what my clients tell me about their natural speech moments—the experiences I describe as accessing their IASN. What gets in the way of that access?
One framework that has helped me understand this question is Internal Family Systems (IFS), also known as Parts Work, developed by Richard Schwartz. IFS describes Self Energy through qualities often summarized as the Eight Cs—curiosity, calm, clarity, connectedness, confidence, courage, creativity and compassion—and the Five Ps—presence, patience, perspective, persistence and playfulness. My clients typically refer to these qualities as Authentic or True Self Energy.
I especially value playfulness. Freedom to express ourselves includes the full range of emotions—we can be excited, passionate, silly, sad or angry. I consistently see freer access to one’s IASN when people feel present, open, playful, curious, and connected to their emotions, their Authentic/True Self Energy, and their listeners.
Natural speech is not the thing we make happen. It is what can emerge when we feel free to be ourselves and freely express our thoughts, ideas and emotions.
With IFS therapy, I now recognize the opposite state when it emerges within myself. When something feels threatening, fearful Parts and my nervous system can automatically respond with protection. These Parts may try to “protect” me from sounding inarticulate, being judged for a poor vocabulary choice, not sounding smart, or feeling lesser than. Their fear and resulting “protection” can leave me feeling flustered, jumble my thoughts, and make me want to escape.
These responses don’t happen in isolation; they operate as an interconnected system.
But my ability to speak has not disappeared.
My access to it has changed.
I believe we have mistaken variability in access for variability in ability.
Looking Under the Hood
After many years of listening closely to PWS describe their experiences, I have come to believe that each person develops an intricate and highly individualized Stuttering System of interconnected protective Parts and responses. I refer to these protective Parts as Stuttering System Parts (SSPs).
And that system does not begin when we hear a stutter.
Before speaking—sometimes minutes, days, weeks or months beforehand—SSPs can become activated in anticipation of introducing oneself, giving a presentation, attending an event or saying a particular word. They can begin preparing the mind and body for perceived danger long before the moment arrives.
During the moment, SSPs may automatically respond to the perceived threat of blocking. They may draw upon strategies the person developed themselves or techniques learned in therapy. SSPs may anticipate an approaching sound or word, figure out how best to avoid it, force a sound out to break a block, go silent, or become extremely focused on how the person is being perceived.
Afterward, other SSPs may respond with shame, humiliation, self-criticism, relief or anger. They may replay the block and ruminate about what happened—sometimes beginning the anticipation of the next speaking experience.
If we focus only on managing the observable stuttering event, we’re seeing a few seconds of a system that may have been operating for weeks.
I believe these protective responses become interconnected and strengthened through repetition, increasingly operating outside conscious awareness—like riding a bicycle.
Just as natural speech is highly automatic, protective responses can become highly automatic too. I don’t see the Stuttering System simply as a learned speech behavior, but as a system of protective Parts whose responses have become automatic. And just as terrain changes for a cyclist, speaking contexts change—the listener, situation, anticipated word or perception of judgment. SSPs automatically adjust their protective responses accordingly. This is why stuttering can feel as though it simply happens. The person does not consciously decide, “Now I’ll activate my fight/flight/freeze response, become afraid of this word, try to avoid it, and block.”
The work is to bring more of this protective system into conscious awareness—not to control speech, but to understand what is happening underneath it. As clients become familiar with their SSPs, they can discover the beliefs, fears and protective intentions driving these automatic responses. As clients understand and resolve the fears of their SSPs, they gain greater access to their Authentic/True Self Energy and can increasingly recognize, trust and identify with their natural-speaking experience as their own.
John Harrison’s Stuttering Hexagon captures this systemic interaction through six interconnected elements: beliefs, perceptions, emotions, intentions, physiological responses and behaviors.
Parts Work adds another lens. I see SSPs operating through and across these interconnected elements.
One Part may anticipate a feared sound or word. Another may scan ahead or try to avoid it. A Pushing Part may force a sound out to break a block. Another may focus intensely on how the person is being perceived. A Self-Critical Part may attack afterward. Another may decide that silence or avoidance is safest.
Every Part has a history, a good intention and a desire to be understood.
Watching the Player, Not Just the Ball
Historically, our clinical attention has understandably been trained on the client’s speech: Where was the block? Which sound was difficult? What happened to airflow or voicing? What should the speaker do to manage being a person who stutters?
In a sense, we have been watching the ball.
But what if we turned our attention to the player?
Who is this person when they speak naturally? What might help them gain freer access to their true nature?
Parts Work turns that curiosity inward. Clients might ask their own Stuttering System Parts: What does this Fear Part believe when I am about to say my name? How does this Fear Part show up in my body? Why does this Part feel the need to “protect” me by blocking me on my name? And my clients find the answers within.
I believe one’s IASN is in alignment with their Authentic/True Self Energy. When Stuttering System Parts feel understood, the person is freer to connect with themselves and others and express what they genuinely think and feel.
To me, this is authenticity. It comes from recognizing something already experienced firsthand. When PWS speak naturally while alone—or in any context in which their IASN is freely accessible—that speech is authentically theirs. It is not an accident or “lucky fluency.” It is theirs to own.
If the capacity to speak naturally already exists, we have an obligation to affirm it—helping our clients recognize, trust and claim it as their own, and understand and resolve what interferes with accessing it.
This year’s theme reminds us there is no single shade of stuttering. I would add one more to the palette:
The person who speaks naturally might also be the person who stutters!
What might we learn if we became just as curious about that person?
References
Constantino, C. D., Eichorn, N., Buder, E. H., Beck, J. G., & Manning, W. H. (2020). The speaker’s experience of stuttering: Measuring spontaneity. Journal of Speech, Language, and Hearing Research, 63(4), 983–1001. https://doi.org/10.1044/2019_JSLHR-19-00068
Harrison, J. C. (2011). Redefining stuttering: What the struggle to speak is really all about (12th ed.). National Stuttering Association.
Jackson, E. S., Miller, L. R., Warner, H. J., & Yaruss, J. S. (2021). Adults who stutter do not stutter during private speech. Journal of Fluency Disorders, 70, 105878. https://doi.org/10.1016/j.jfludis.2021.105878
Schwartz, R. C., & Sweezy, M. (2019). Internal Family Systems therapy (2nd ed.). Guilford Press.
Hello and thank you for reading my paper, I look forward to your questions and comments 🙂
October 5, 2026
The author of this “Comment” writes the following as an email response to Marjorie Foer’s recent ASAD post titled “A Person Who Speaks Naturally—and Sometimes Stutters.” My comments are in parentheses under the following six powerful quotes I’ve pulled from your paper:
1. “They already know how to speak. So why teach them how?”
(Extremely well stated. You couldn’t have asked an SLP a more probing question. Indeed, every SLP who reads your paper will be strongly challenged to get real about the extreme importance of cognition in stuttering. I remember a famous quote from years back: “If it ain’t broke, don’t try to fix it.” Absolutely, stuttering treatment should focus on the fact that, in some contexts, the person who stutters (PWS) is most often fluent. I believe that these PWS have learned two speaking strategies – fluency and stuttering. The question that makes the difference is “how does the PWS know when to trigger their stuttering strategy and when to trigger their fluency strategy?” This is a matter of cognition, not genetics or physiology. IT IS A LEARNED BEHAVIOR, AND IT CAN BE UNLEARNED.)
2. “I call this capacity the Innate Ability to Speak Naturally (IASN)—an ability PWS recognize firsthand when their speech emerges naturally, spontaneously and without deliberate management. In those moments, they simply speak, much as a person who does not stutter speaks.”
(Yes, yes, absolutely. Way to go, borrowing from the acronym “IASN.” That is a stroke of brilliance! I just learned from Marjorie that she wasn’t aware of their similarity. That is how the unconscious works. It does things for us that we aren’t aware of, both good and bad.)
3. “Recognizing (their) that the IASN invites PWS to notice, become familiar with, and increasingly identify with who they are when speaking feels natural, comfortable and authentic—because it is all of these!”
(I love how you challenge the IASN to consider the natural conclusion of their own belief system about stuttering. Well done, Marjorie, well done.)
4. “Why teach greater attention to speech when PWS tell us their natural speech emerges when they aren’t paying attention to it?”
(If it weren’t so sad, your 4th statement would be almost laughable. After my many years of working with PWS, my sadness deepens for the thousands, and yes, millions, of PWS who will not learn what triggers (causes) them to stutter. So many spend their lives in anxiety, shame, guilt, low self-esteem, depression, etc.
(So many build their careers around work where their stuttering doesn’t cause them personal grief. This truth affects not only the PWS but also the family immensely. The family suffers financially because their stuttering parents don’t reach their full potential in their desired career.
(Wake up, SLP community! Are you well-meaningly trapping your stuttering clients into continuing to live such defeated lives? Please, please read closely the powerful paper Marjorie has given you and begin researching the cognitive view of stuttering.)
(Your statement captures my beliefs about this: “Natural speech is not something we make happen. It is what can emerge when we feel free to be ourselves and to express our thoughts, ideas and emotions.”)
5. “After many years of listening closely to PWS describe their experiences, I have come to believe that each person develops an intricate and highly individualized Stuttering System of interconnected protective Parts and responses. I refer to these protective Parts as Stuttering System Parts (SSPs).”
(I found much truth in your informative section, which you metaphorically call “Look Under the Hood.” Marjorie, have you ever shone in this section? SLP’s, pay close attention to this section. In this section, Marjorie addresses the most effective metaphor for healing your triggers of blocking and stuttering, “Parts.” These unconscious “parts” must be uncovered and healed so the PWS can reduce their strength and, yes, even eliminate them forever through reframing. Marjorie cites John Harrison’s book, “Redefining Stuttering: What the Struggle to Speak Is Really All About” (12th ed.). Read it! You will be glad you did.
(Marjorie stated, “Every Part has a history, a good intention, and a desire to be understood.” Yes, these unconscious parts all have a positive intent for the PWS. PWS, which unconscious part is the main driver of your stuttering? Is it the fear of stuttering? Is it feeling threatened when you have to speak to an authority? Is it feeling less-than? Is it the fear of rejection? What belief, idea, thought, feeling, etc. is behind your trigger for choosing your stuttering speaking strategy?
(What emotional part is the main driver (trigger) of your stuttering? What is its higher purpose for you? What does it really want for you? Acceptance? Appreciation? Understanding? Keep asking yourself, “What does this part (name it) want for me?” When you get an answer, keep asking that question for each answer you get. “And what does that part (name the previous answer) want?” Keep asking each answer until you reach the part’s highest purpose. It is the key to healing the part. Apply your highest purpose to that old negative part that lies at the root of your triggering painful part. This methodology comes from Neuro-Linguistic Programming (NLP) and Neuro-Semantics, which I co-developed with L. Michael Hall, PhD.)
6. “The work is to bring more of this protective system into conscious awareness—not to control speech, but to understand what is happening underneath it. As clients become familiar with their SSPs, they can discover the beliefs, fears and protective intentions driving these automatic responses. As clients understand and resolve the fears of their SSPs, they gain greater access to their Authentic/True Self Energy and can increasingly recognize, trust and identify with their natural-speaking experience as their own.”
(Way to go, Marjorie. You have written a paper that needs to be circulated throughout the SLP community. I encourage you to send it to every SLP and PWS organization that publishes newsletters, both print and digital. Your extraordinary paper needs to be read by every SLP and PWS you can reach.)
Thank you for all the effort that you have put into this paper. It is absolutely awesome.
Dr. Bob Bodenhamer
Hi Bob,
Thank you so much for taking the time to comment on my paper. I appreciate you responding to what you called “the six powerful quotes.” I believe that you’ve mined the most vital nuggets that I want our beloved community to consider. I’m reposting them below as a summary of key points for SLPs, PWS, parents and researchers. I’m encouraged to have your support, Bob. I know we see stuttering in the same way – as a complex learned behavior that can be unlearned. The evidence is there, baked into the six key points.
I understand that for many, it can be difficult to embrace an inverted perspective on stuttering, one that sees that (probably most if not all) PWS have the Innate Ability to Speak Naturally and can learn to trust this ability as real and not “lucky.” This perspective encourages clients to identify with their IASN, not their stuttering. It empowers them to discover for themselves what is driving their Stuttering System and, disempower it. We know that people have learned how to dismantle their Stuttering Systems and this deserves to be included as a valid course for treatment and for researchers to study.
1) “They already know how to speak. So why teach them how?”
2) “I call this capacity the Innate Ability to Speak Naturally (IASN)—an ability PWS recognize firsthand when their speech emerges naturally, spontaneously and without deliberate management. In those moments, they simply speak, much as a person who does not stutter speaks.”
3) “Recognizing that the IASN invites PWS to notice, become familiar with, and increasingly identify with who they are when speaking feels natural, comfortable and authentic—because it is all of these!”
4) “Why teach greater attention to speech when PWS tell us their natural speech emerges when they aren’t paying attention to it?”
5) “After many years of listening closely to PWS describe their experiences, I have come to believe that each person develops an intricate and highly individualized Stuttering System of interconnected protective Parts and I refer to these protective Parts as Stuttering System Parts (SSPs).”
6) “The work is to bring more of this protective system into conscious awareness—not to control speech, but to understand what is happening underneath it. As clients become familiar with their SSPs, they can discover the beliefs, fears and protective intentions driving these automatic responses. As clients understand and resolve the fears of their SSPs, they gain greater access to their Authentic/True Self Energy and can increasingly recognize, trust and identify with their natural-speaking experience as their own.”
All the best,
Jorie (Marjorie)
Reading this made me think of something from around 2020, when I was still working out my own approach. I met a lot of adults who stutter who described the same thing: the start and the end of a conversation are hard, but somewhere in the middle it feels easy and the words come out fine. Most of them wanted to train that middle part until it covered the whole conversation.
Over the years since, I have met many more people who stutter, and an enormous range of ideas and methods about it. Gradually I came to think that this is not really a question of theory. Most of the theories are correct, and the phenomena they describe do objectively happen. The problem is that it cannot be executed — and it cannot be reproduced.
Telling someone not to pay attention to how they speak is like telling them not to think about an elephant. And the middle of a conversation isn’t something you can build or stretch; it’s just the part between the two ends.
So what I’m curious about now is: when it does happen, what actually changes inside? And what would have to change for it to stay?
One last thought, offered as a reminder rather than as criticism: noticing the problem and drawing a conclusion are only the first two steps. You have the conclusion — but you cannot reproduce it reliably yet. There is still one step beyond that, triggering it fully, and only there does it become something that can actually be executed.
Hi Liu Hua,
Thank you so much for reading my paper and sharing your experiences and thoughts regarding my approach. I would love to know what your approach is, if you would care to share it here.
I will do my best to respond to your comments and questions, but I am not certain that I fully understand each one, so I would appreciate you clarifying your thoughts if I misunderstood you, and I will happily try again to respond to your question.
When you ask “when does it happen, what actually changes inside? And what would have to change for it to stay”, I am assuming that you want to know when does the person who stutters (PWS) start accessing their Innate Ability to Speak Naturally (IASN) and when does it stay?
The answer is that after we meet a Stuttering System Part (SSP) and the PWS is able to see how hard this SSP has been working to protect/prevent them from stuttering, or the repercussions of stuttering, the client gradually develops understanding and compassion for this Part. Let’s go with a common SSP, Doubt. Pretty much everyone I’ve worked with expresses doubt that they will be able to say their name in certain situations without stuttering.
It seems that when a client is able to consistently turn toward Doubt with compassion and forgiveness, this part gradually loosens its control and backs off, allowing the PWS to say their name with ease/access their IASN.
If there is a related SSP that holds the belief that the client will stutter on their name in specific situations, such as time pressure, with strangers, authority, lots of listeners, or whatever the circumstance, then we need to understand and feel compassion and forgiveness for that particular “circumstance part”. This is a simplified explanation of Internal Family Systems (IFS or Parts Work). You can watch some videos that introduce you to IFS. Even though the speaker is not talking about SSPs, you may be able to see how this works with SSPs. Here is someone who has a wonderful series of videos that explains IFS:
https://www.youtube.com/watch?v=tNA5qTTxFFA.
I’m not totally sure what you are asking in your final paragraph, but I’ll see if I come close to answering your concern. My clients learn to identify and feel more comfortable accessing their True Self Energy. It is from this True Self Energy that they learn to develop a relationship with their SSPs. Once the SSP feels seen, heard, appreciated, understood, validated and forgiven, they begin to relax and the client is no longer blocked from using their IASN.
I never teach them to not think about stuttering and I don’t teach them how to speak, it’s not necessary, they already know how to speak. I teach them to understand that SSPs have the best of intentions – to protect them from harm – but they are misguided and “frozen in time” from when they were “born” (came to the rescue).
To summarize, my clients become comfortable identifying with their True Self Energy/Authentic Self which puts the SSPs at ease and allows them easy access to their Innate Ability to Speak Naturally.
Please let me know if I answered your questions and concerns.
All the best,
Jorie
Thanks for the reply — it cleared up a few things for me. It also reminded me of groups of people who stutter that I met years ago. One group had a belief: when they weren’t thinking about it — when they forgot they stutter — their speech was fine. So they wanted to train themselves into that state.
Looking through other work on stuttering, I noticed something missing. Any kind of intervention comes with side effects — medicine treats an illness, but medicine has side effects. Work with people who stutter, especially anything at the level of changing how someone thinks, doesn’t only affect speech; it affects other parts of life too. Like the film Inception: put an idea into someone’s memory and it changes what they think and do in real life — but if you put it in the wrong place, you get the wrong result.
But nobody seems to pay much attention to that, or to ask whether it’s worth it — whether what you get in speech is worth what it costs elsewhere.
I watched the video you sent. It mentioned not worrying about the other person’s reaction, good or bad. That made me think of something: feedback is a protection. It’s like pain — nobody wants pain, but without it you can’t tell when something is harming you, and that gets dangerous.
About my last question — what I meant is that once you think you’ve found the answer, you have to check it again and again before you can call it one. Not luck, not “it happens sometimes”, not something that depends on a process you can’t reproduce. If it only turns up by chance, or only with a particular person in a particular situation, then the root of the problem hasn’t really been solved — it’s just something that happens to show up.
My own work on this goes in a different direction from yours. I went back to the starting point: if the problem is in how the words come out, then fix that, and leave the rest alone. Or I’d put it better this way — pull stuttering out from everything else.
Here’s an example. Two people giving a speech. The first one stutters — prolongations, repetitions — but their tone and their bearing are easy and composed. The second one goes pale, their body shakes, they’re sweating — but their speech itself is normal.
Which of them is “the one who stutters”? I would say the first one stutters, and the second one speaks normally.
That’s what my work does — it separates them. Stuttering is stuttering. The other problems are other problems.
Thank you for filling me in more about your thinking and your approach. The “side effects” of IFS are access to one’s Innate Ability to Speak Naturally – the Stuttering System is de-activated. It allows the person to speak with ease, naturally. Here’s a side effect that a client told me last week, “I no longer have good days and bad days. I’m having a good life.”
I agree that the first person in your example exhibits stuttering and the second one doesn’t, but seems to have an extreme fear response to giving a speech. I have plenty of clients who exhibit both kinds of behaviors, extreme or even minor physiological reactions along with stuttering. It seems to go hand in hand with the people who seek therapy. It’s not just the stuttering that they express as a problem but the rest of the Stuttering Hexagon: Emotions, Physiological Responses, Beliefs, Perceptions, Intentions and the Behavior of stuttering. So I treat the entire Stuttering System.
The current paradigm has people focused on neurological differences as the cause of stuttering. I see those differences as the effect of stuttering. In other words, practicing a stuttering pattern shows up in the brain and makes it feel real, because it is. But if the client experiences times when they don’t stutter, that is also real and we focus on developing this innate ability to speak with ease.
This is a holistic, inward-looking therapy, instead of outward looking therapy. We come to understand what makes the client’s unique Stuttering System work the way it does. The client is no longer bothered by the perceptions of others because they find peace in understanding who they are, and if there’s a moment of stuttering, they have the calm and presence of mind to let it go. That moment doesn’t define them or make their Stuttering System kick into gear because the triggers are no longer activated.
Are you finding that your clients feel confident, calm, present and connected with their listeners? Are they able to speak naturally and not focus on their speech while speaking? Are they no longer fearing certain speaking situations?
One thing I do agree with you about: seeing the neurological differences as the result of stuttering rather than the cause — something that practice puts there.
We’re looking at different things — but for me the real problem is execution. It has to emerge right away, not after ten minutes of getting ready, but be there in a conversation whenever you need it. Because that’s what ordinary talking is like — it doesn’t give you time to prepare.
If by execution, you mean speaking spontaneously, when the urge strikes, that’s what happens for my clients over time. It’s not something that emerges right away in therapy. It takes time for the protective parts to trust one’s True Self Energy – that this calm, confident, present person who feels the urge to speak will remain in that state. Sometimes other parts jump in and take over when one part starts relaxing. Stuttering is a complex system, and in my experience, at least for the people that come to see me, the impact of stuttering includes a trauma response. Therefore I use a trauma treatment modality, IFS, to heal the entire person, not just their speech.
Thank you for your warm replies. I think this conversation can come to an end here. Before it does, I would like to leave you two things from my own experience.
1. What changes is not the outer situation. What changes is what that situation means, relative to what a person can do.
When the outer situation changes, the inner state re-matches to it — and it re-matches very fast. As a rule of thumb from experience, the figure I use is 50% in a day.
Take the nervousness a person who stutters feels when speaking. Once their speech is back to normal, all it takes is three or four conversations a day, two or three sentences each: the nervousness is down 50% on day one, 75% on day two, and 87.5% by day three.
By “the outer situation” I mean things like a person’s position, the outcome, and the purpose.
For example, someone who cannot swim is afraid of the water. Teach them to swim and the fear goes away — nobody has to work on their psychology; you only have to teach them to swim. Or: a cyclist hates it when drivers honk. Give them a car, and they stop hating it.
Rather than spending effort changing the mind, change the situation and the mind follows by itself. So if the purpose is to actually solve a problem, I don’t think over-attending to the psychology matters much.
2. We are still looking at the core of the problem differently.
A method can be good, elegant and effective — but if the process is too long, the cost too high, or the margin of error too wide, then for solving stuttering it has no value.
Here is an example. Someone wants to build muscle and needs more protein. The usual way is a protein powder, but it is expensive and many people cannot afford it. What then? Boiled eggs do the same job.
Your method is not wrong. It has a precondition that is not written down: that the person has money and time.
Maybe the environments we work in are different. There is a phrase here — “prevent poverty caused by illness.” That is probably where the difference in how we see this comes from.
Hi Jorie,
Thanks for a great paper, one that left me nodding my head in parts.
As a person who stutters who spent more than half of my life trying to hide it, and was fairly successful at that, I appreciate deeply your main premise of curiosity.
Sometimes PWS wind up in therapy not knowing what they want. After a devastating experience of being fired from a 22+ years held job, (because of stuttering) I decided to explore therapy when I discovered there was a program near me that I’d never knew existed until I typed the word stuttering into the internet for the first time.
I was curious to see what therapy was about, since my father had refused to allow me to participate as a kid when it had been recommended in third grade.
The clinicians I worked with didn’t seem overly curious about me and the “why” behind my 35 year experience with covert stuttering. They were almost exclusively focused on teaching me fluency shaping techniques. I quickly realized that’s not what I needed. I just needed someone to tell me it was OK to stutter and be ME, in all my true shades, stuttery, fluent, and everything in between.
I didn’t last nine months in that program and comfortably walked away.
How would you encourage anyone working with a pws to foster curiosity and demonstrate that curiosity is valid within a therapeutic alliance?
Pam
Hi Pam,
Thank you for sharing your previous experiences with stuttering affecting you in the workplace and with the therapeutic environment and approach you encountered. You shared that you were curious to see what therapy was about. You lead with the Self Energy of Curiosity, and continued to wonder “how is fluency shaping helping me?”, came to the conclusion that it wasn’t and promptly left that world behind.
That’s the power of curiosity in a nutshell. It’s generated from within, it’s a state of mind that we can sense and feel, it’s an openness and willingness to learn with genuine interest.
To foster it with clinicians, I think one needs to believe that the client holds all the answers about their Stuttering System (SS) and it’s up to us, the clinicians, to ask the kinds of questions that help the client uncover the answers. We’re not the experts on their SS, they are, and by modeling curiosity, it becomes safe for the client to begin to explore what creates and maintains their SS. Curiosity holds no judgment, it is purely the state that involves us in the process of discovery.
I can’t imagine engaging with a client and not being curious about how they felt prior to, during and after blocking on their name. What were their thoughts, what beliefs do they hold around being able to say their name in different situations and circumstances.
For example, using the IFS approach in therapy, I would start by asking:
“Where to you feel this “Block on my name” Part (SSP) most in your body?
Answer: In my chest and throat.
Question: What does it feel like?
A: It feels tight, and there’s some pain, even like burning”
Q: Can you see this part? If so, what does it look like?
A: It looks like a chain, a heavy chain.
Q: Is this heavy chain willing to give you just a little space and step outside your body? Silence.
I wait, curious to find out about the answer.
A: Yes, it’s a few inches away.
This is a glimpse into the beginning of Parts work with clients. Curiosity is the foundational vehicle for creating relationships with the Parts and the client. Even if a clinician isn’t using Parts Work, it’s important to be curious about how the client feels in different situations, what their beliefs and perceptions are, what their physiological and behavioral responses are and what their intention is in a given situation. You need curiosity to find the answers to those questions.
To lead with curiosity it starts by noticing if I’m curious about what is going on for my client right now. That of course requires Presence – presence of mind to ask oneself “How am I relating to my client right now? Am I telling the person how they should be thinking, believing and behaving? Or am I wondering about what their immediate needs or beliefs are? How can I find out their immediate needs? I can ask “What would you like to focus on today?” “What do you notice happening just before, during and after the moment of stuttering?”
Thanks for giving me the opportunity to explain a little more about using Internal Family Systems (IFS) and how curiosity, one of the Self Energies, is a vital force for discovering how a particular client’s Stuttering System operates.
All the best,
Jorie
I really enjoyed reading your article! I am currently taking my first fluency course as a graduate student in speech-language pathology, so I still have a lot to learn about stuttering. Your article was very interesting and gave me a different perspective on how stuttering can vary depending on the situation. One thing that stood out to me was how people who stutter may speak naturally when they are alone but experience stuttering when speaking to others. I had never really thought about how much the presence of a listener could impact someone’s speech. Your article helped me understand the importance of looking beyond the stuttering itself and considering the emotions, fears, and experiences of the individual. As a future SLP, I think this is something important to keep in mind when working with people who stutter. Thank you for sharing your perspective!
Hi Emily,
I’m glad that you enjoyed my article! Your open-mindedness and curiosity for understanding what is happening for the client will lead you to what you and your client need to discover. I believe that these qualities, along with compassion and presence will make you a stellar SLP. You’re in a wonderful field of study and service and I hope that it brings you the same kind of fulfillment and joy that it continues to bring to me.
Wishing you all the best,
Jorie
Hello Jorie
Thank you for sharing your beliefs and ideas regarding stuttering. I agree: there are different beliefs and ideas, and it is valid and good to share and discuss them. I do, however, disagree with your premise and with your approach.
You write “What can we learn from the times when a person who stutters speaks naturally?” Your premise that stuttering is unnatural is incorrect, in my view, since (a) it perpetuate the stigma of stuttering as a defect (whereas stuttering is simply a characteristic of speech, a speech difference), (b) it is contrary to what is known about the neurobiology of stuttering, and therefore (c) stuttering is a completely natural way of speaking – for people who stutter. It is simply the way that we talk.
It is also incorrect that “we” have not been curious about the variability of stuttering and the absence of stuttering – in some people, not all – when speaking alone. It’s a fascinating aspect of stuttering, one that many others and I have thought about and discussed for years. Stuttering is variable. It changes with time, and, yes, it might change with situations. What also changes, and this is what is often overlooked, is the struggle to avoid stuttering. It is of crucial importance to understand and differentiate between stuttering, our natural way of speaking that arises from our neurobiology, and struggle. Struggle refers to those secondary behavioral characteristics of stuttering that manifest when we try to avoid stuttering. Struggle is what creates, in many cases, so-called “severe” stuttering.
On the other hand, when we let go of trying to avoid stuttering, when we just stutter, just allow ourselves to be, we are comfortable and authentic with ourselves and with our stuttering.
So why does stuttering have situational variability? That can be explained by stigma, self-stigma, shame, fear, and complex trauma. The problem is not stuttering, it is stigma and all that arise from stigma. When we push back against the stigma, when we understand fear and shame and we can release them, when we understand and deal with the complex trauma that we have experienced, we are free. We stutter freely. That does not mean that it is easy. It is, however, neither good nor bad. It simply is. Some things that we deal with in the journey of life are hard. So what? Wishing it weren’t so does not make the difficulty go away. Rather, when we approach stuttering with non-judgment, with curious observation instead of with criticism, when we embrace our stuttering with mindfulness and with deep investigation, we become free to simply stutter.
We do not stutter because we are trying to manage our speech. We do not stutter because we are thinking about stuttering. We do not stutter because we are trying not to stutter. This “natural speaking” idea, the idea that if we don’t think about stuttering then we won’t, is nonsense. Stuttering is natural – for those of us who stutter. We just stutter. Why do you think that we need to learn to speak differently? That approach is just an expression of stigma.
When I stutter – without struggling to avoid stuttering – I feel absolutely calm. I feel presence, I feel confidence, I feel authentic. I connect and I communicate – all while stuttering. I have very little premeditation. I speak effortlessly, as much as is possible for a person who stutters, when I do not fight against stuttering. I stutter, but I do not struggle.
When I forget myself and the old fear and shame come up – and they will, since they are trauma responses – then I find myself struggling once again as I try avoid simply stuttering.
And sometimes, my stuttering is naturally more difficult than other times. It’s part of the variability of stuttering. It is just what it is. The way though is by understanding and accepting that this is OK, this is the way I speak. That does not imply resignation, nor does it imply victimhood or having my very being identified with stuttering. I go out and live life as much as I am able. In my case, social anxiety often impedes me, and it is almost certain that my experiences of the stigma of stuttering created, or certainly fed, the social anxiety, but that is different, separate topic. I know many PWS who stutter completely openly and do not feel social anxiety. That said, social anxiety, too, is a spectrum.
There is no such thing as Innate Ability to Speak Naturally. Stuttering is a completely natural way of speaking – for people who stutter. I speak completely naturally when I stutter. Your implicit declaration that stuttering is unnatural is actually quite harmful. With an attitude of mindfulness – non-judgemental observation in the present moment, with acceptance and with “investigation of phenomena” (what I feel, what I believe, what I am attached to, what I desire, what I am averse to, and so on) – I am free to be my authentic self. I stutter. So what? Your eight C’s and five P’s are all possible while I stutter.
Thanks for writing. Wishing you well.
Hanan
Hello Hanan,
Thank you for your thoughtful response and for sharing your experience so openly. You describe feeling calm, present, confident and authentic while stuttering. I agree that these qualities, including the Eight Cs and Five Ps, can be experienced while a person stutters.
I do want to clarify what I mean by “speaking naturally.” I intend it to describe experiences my clients report in which speech emerges spontaneously, comfortably, without stuttering and without deliberate management. I do not intend to suggest that someone who stutters is unnatural, less authentic or less fully themselves. I recognize your concern that contrasting “stuttering” with “speaking naturally” can imply that judgment. In my paper, I use “natural” to describe how these particular speaking experiences feel to my clients.
The talk-alone effect has a research history extending well before Jackson and colleagues’ 2021 study. Their paper reviews earlier investigations and addresses a difficult question: how can researchers establish that someone truly perceives their speech as private? My invitation to greater curiosity concerns what these experiences reveal about the speaker’s capacity, what they mean to the person experiencing them, and how we might use that understanding in therapy. Jackson and colleagues, 2021
The distinction between stuttering and the struggle to avoid it is familiar within our field and informs my work. Your description of letting go of avoidance and finding greater freedom in communication offers a point of connection. I help clients approach their protective responses with curiosity and compassion, and IFS provides a framework for doing so.
Where we may differ is in how we understand the moments when stuttering diminishes or is absent. My clients tell me that sometimes words simply come, without planning how to say them or trying to prevent a stutter. I believe those moments tell us something important about an ability they already possess.
Consider knowing an answer but finding that your mind goes blank during a test. Later, the answer comes to you easily. You had the knowledge all along; what changed was your access to it. This illustrates the distinction I am making between having an ability and being able to access it in a particular moment.
I call that underlying capacity the Innate Ability to Speak Naturally. My clients do not need to dismiss those experiences as accidents or “lucky fluency.” Those moments are theirs, too. Just as you value the freedom to stutter openly, they value discovering and trusting their IASN. For them, this change in perception and belief changes how they see their speech, themselves and the world around them.
In my clinical experience, as clients understand their protective Parts and resolve the fears those Parts carry, access to their IASN can become freer and easier. They describe speaking from their hearts, connecting with their listeners, expressing what they actually want to say and feeling true to themselves. They also report doing so without stuttering in circumstances where they previously stuttered, such as ordering food, introducing themselves and speaking in groups. These changes are part of the experience I am trying to understand and describe.
You emphasize neurobiology. I do not see neurobiology and the possibility of change as competing ideas. Neuroplasticity means that the brain can change with experience and learning. For example, a controlled study found changes in gray matter concentration following an eight-week mindfulness program. Our experiences can leave a physical imprint on the brain. Hölzel and colleagues, 2011
Research also shows that people can experience substantial improvement in trauma-related symptoms, including after repeated childhood trauma. Protective responses need not remain fixed forever. That research does not establish an explanation for stuttering, but it supports taking the possibility of change seriously. Van Vliet and colleagues, 2021
The question of cause and consequence in stuttering neuroimaging also deserves care. Researchers examine both early differences that may contribute to stuttering and changes that may develop through living with it. A brain difference does not, by itself, tell us the entire story of how it arose. Chang and colleagues, 2019
In my clinical view, anticipation, fear, struggle and protection can become deeply interconnected through repetition. These patterns may become so automatic that a person is unaware of them. I believe they can interfere with access to an existing speaking ability, and that understanding these patterns and resolving the fears behind them can make that ability more freely accessible. This is how I interpret patterns my clients and I observe across moments of stuttering and moments when speech comes freely. Research has not settled every question about cause and consequence, but these experiences deserve investigation.
I am therefore not suggesting that someone can simply decide to stop thinking about stuttering and stop stuttering. Becoming aware of automatic protective responses, understanding them and changing those patterns involves a process. It is very different from being told to “just stop thinking about it.”
The shift in perspective I am inviting is from focusing primarily on the difficulty to also recognizing the capacity. As I describe in my paper, it is like widening our attention from the ball to the player: we become curious about the whole person, including the moments when speaking comes easily and what those moments mean to them.
For a client who has become familiar with their Stuttering System Parts, ordering food might offer an opportunity to draw on that understanding. The question can shift from “What must I do to get these words out?” toward “I have experienced words coming freely. What helps me access that ease?” In my view, this opens a possibility for discovery and new experiences of speaking that may, through neuroplasticity, support lasting change. Every person deserves patience, respect and a full opportunity to communicate whether they stutter or not. Their wish to explore change can be welcomed alongside that unconditional respect.
That is what I hope this shift brings: more room for people to understand themselves, recognize their capacities and choose the direction of their own therapy. Acceptance and curiosity about change can exist together.
Following the client’s lead remains central to my work. You describe freedom in allowing yourself to stutter. My clients also describe freedom in discovering and trusting their IASN. People with different experiences, perspectives and goals need treatment options that respond to those differences. Respecting your experience and respecting theirs are equally important.
My paper invites curiosity about an ability my clients already experience—and about what helps them access it more freely. That curiosity is consistent with this year’s invitation to recognize different shades of stuttering.
Warmly,
Jorie
Hello Jorie! What specific clinical practices help clients reduce the perceived listener/evaluation threat while avoiding increased self-monitoring (e.g., focusing on airflow/rate), especially during high-stakes speaking?
Hello Magdalena,
Thank you for this thoughtful question. In my work, I help clients become curious about the Parts of themselves that experience a listener as threatening. We explore what those Parts fear and what they are trying to protect against. This is a process of self-discovery that develops over time, rather than a quick strategy to apply just before a high-stakes speaking moment.
For example, a client anticipating a presentation might notice a Part saying, “They’ll think I’m incompetent if I stutter.” I might invite them to turn toward the Part carrying that concern and gently inquire: “What are you afraid would happen if someone judged me? What would that mean to you? What would you like me to understand?” This may be an Inner Critic or another protective Part; we let the client discover how they experience it. We leave room for their own answers, without assuming what the fear must be or demanding that the Part relax.
Sometimes another Part interrupts: “Who cares what they think? Just push the word out already!” We become curious about that Part, too. What is it afraid would happen if it didn’t push? Using the IFS framework, we explore how these seemingly opposing Parts may both be trying to protect the person. The aim is to understand them and develop a different relationship with them.
A second example involves the Inner Critic after a speaking experience. A client might notice the automatic thought, “That was awful. Everyone must think I’m stupid.” We can help them recognize, “A critical Part of me is saying that,” creating some room between the thought and what they believe about themselves. We then explore what the Critic hopes to accomplish and what it fears would happen if it stopped criticizing.
Alongside this discovery, I encourage unconditional kindness and compassion toward themselves—including toward the frightened, pushing and critical Parts. Kristin Neff identifies three elements of self-compassion: mindfulness, common humanity and self-kindness. Drawing on her work, we can acknowledge the client’s feelings and respond compassionately to their protective Parts:
Mindfulness: “This is a difficult moment. I notice fear and self-criticism.”
Common humanity: “Feeling vulnerable or fearing judgment is part of being human. I am not alone.”
Self-kindness: “I deserve care and understanding right now. I can be on my own side.”
These examples draw on Neff’s explanation of self-compassion. Clients can find their own words; there is no script they must perform correctly.
During a speaking moment, a client who has become familiar with these patterns might simply recognize, “That worried Part is here,” and meet it with kindness before returning attention to what they want to communicate. The deeper exploration can happen later. They do not need to analyze their Parts while simultaneously trying to speak, or become calm before participating.
I also encourage a generous supply of acknowledgment when they notice even a small change: “My Inner Critic backed down a little,” or “I caught that harsh thought and responded kindly.” Depending on age and personality, that might call for a “Way to go!” a “Hell, yeah!” or a happy dance. We celebrate curiosity, courage and kindness toward themselves and their Parts, whether or not they stuttered.
If the Critic remains loud, they still deserve that same compassion. Within this framework, we can understand its persistence as an invitation to offer even more patience, love, understanding, curiosity and acceptance. We are building trust with that Part, allowing time to understand why it feels such a strong need to protect.
Some clients replay a difficult speaking moment immediately afterward. They find it hard to feel present or reconnect with others. They may describe their Stuttering System as being in high gear, with automatic protective responses taking over their attention and leaving them feeling driven to fight, flee or freeze.
At those times, I often offer the image of clouds passing through the sky: “Let the moment pass. Let the thoughts and feelings about it move through, too. You don’t have to chase the cloud or hold it in place.” Letting go is an invitation. If the thought returns or the feeling stays, that deserves compassion, understanding and exploration, too. Clients have told me they love this image and that it helps them return to the present and feel ready to engage again.
The distinction I make is between briefly noticing an internal response to a listener or situation and continually monitoring how speech is being produced. Over time, our work builds familiarity with automatic fears, physiological responses, perceptions, beliefs, intentions and behaviors. My aim is for clients to meet those experiences with greater understanding and find it easier to return their attention to what they want to express and to connecting with their listener.
Finally, we also consider the listener and the environment. If someone is interrupting, rushing or ridiculing the speaker, that deserves attention and advocacy. The responsibility for respectful communication does not belong to the speaker alone.
Warmly,
Jorie
Hi Jorie, I loved this article and especially your analogy about focusing on the player not just the ball when looking at their secondary behaviors. How do you incorporate this concept into therapy and make the client aware of their own secondary behaviors?
I’m delighted that you loved my article! And I’m glad you’re curious about focusing on the player, not just the ball.
I intended the “player” to represent much more than secondary behaviors. The ball is what we can observe—the stutter or behavior. When we focus on the player, we become curious about the person’s entire Stuttering System: their emotions, beliefs, perceptions, intentions, physiological responses and behaviors, as described in John Harrison’s Stuttering Hexagon. I place True Self Energy at the center of this interconnected system.
In therapy, I don’t begin by targeting a particular behavior. I follow the client’s curiosity. For example, if someone wants to understand why they have difficulty saying their name, we might get curious about what they call their “Saying My Name Part.”
Instead of asking, “How do we stop this behavior?” we ask that Part, “What are you afraid would happen if you didn’t do this?” We listen to its answers and come to understand what it is trying to protect.
So rather than simply trying to change what the ball is doing, we’re getting to know the player—and understanding why the behavior makes sense within that person’s Stuttering System.
Thank you for your question,
Jorie
Hello Lori,
I first off want to say how insightful your article is! As a Speech graduate student, I have been taught to listen to our clients who stutter and their feeling and concerns regarding it. I have never thought to focus on how the feel when speaking naturally. I was wondering how you first came to to this idea?
That’s a great question Saige, I’m guessing that the curiosity likely began when I started stuttering in my early twenties and then was able to stop stuttering, but continued having difficulty expressing myself. I recognized the truths portrayed in John Harrison’s Hexagon, the six interconnected elements were all there for me before, during and after stuttering and all continued when the stuttering stopped but speech anxiety remained. Just like John, I studied myself a lot. I knew that I could speak with ease in certain situations or with certain people, to me it was obvious that stuttering is situational. So I began working with my clients through that lens, and so far, they’ve all agreed, stuttering is situational.
All the best,
Jorie
Hi Jorie! Thank you for sharing your experience and knowledge with us! While I was reading your article, I enjoyed how positive your approach to speech therapy is. I feel like a lot of traditional therapy to address stuttering focuses on the elimination/reduction of the “negative” primary and secondary behaviors. During these assessments, the “non-stuttered” moments in people’s lives often get overlooked. I loved how you asked your clients to self-reflect on those moments so they can have a greater understanding of their stuttering, since stuttering therapy treats the person holistically in times when they do not present stuttering. In addition, I loved how you go into investigation mode with a “playful” mindset. Thank you for the great read!
Hi Jillian,
Yes, you expressed what I did not explicitly say – that this approach is holistic, looking inside the client, outside in the environment and honoring the delicate eco-system within.
Our Parts play certain roles, and if their role is threatened or eliminated, there is a natural recalibration inside the client – which can create unwanted outcomes, like Parts becoming more stalwart in their roles. We need to get to know the Stuttering System Parts (SSPs)from a place of true curiosity and compassion. When the Parts see that there is enough True Self Energy showing up in the client, the SSPs begin to loosen their grip and allow easier and more consistent access to the client’s Innate Ability to Speak Naturally.
Keep your focus on finding the positive and you will achieve great outcomes with your clients,
Jorie
Hi Jorie, I liked your emphasis on staying curious about each clients’ experience. It made me wonder about someone who finds it hard to explain what they feel when they stutter. How would you help them explore their feelings without accidentally suggesting answers for them? Thank you for your time.
Hello,
Internal Family Systems (IFS, or Parts Work) is totally client centered. The assumption is that I don’t know anything about what’s going on inside for the client, but the parts know exactly why they behave the way they do. So it wouldn’t be appropriate to suggest answers about feelings or anything else that goes on inside them because I honestly have a clue. That being said, in the early stages of therapy, I am likely the one to ask certain types of questions so that we can begin to understand why certain Stuttering System Parts behave the way they do. Initially it’s difficult for a client to speak to a part from their own curiosity – “opposing parts” rush in and voice anger and frustration with the parts that make client block. Once the client gets the hang of being curious and truly wanting to understand why a part does what it does, they can often take the lead with the questions and find the answers within on their own.
Hi Jorie, thank you for sharing your article. As an SLP graduate student, this gave me a new perspective that I hadn’t thought of before. I appreciate that rather than teach our clients articulation, airflow, rate, etc. strategies to speak naturally we can focus on the times they do speak naturally by influencing the environment, listener perception, and using cognitive behavioral strategies. I have a lot more to learn, but this is a wonderful article to add to the tool box, thank you!
Hi Amelia,
Thank you! I’m delighted that the article gave you another perspective to add to your toolbox, especially while you’re still exploring different approaches as a graduate student.
I want to clarify one small but important distinction. We don’t actually try to influence the environment or change the listener’s perception. Instead, we become curious about why the person’s speech changes across environments and listeners. Those differences give us valuable information about what may be happening within their Stuttering System.
I also use Internal Family Systems (IFS), or Parts Work, rather than cognitive behavioral strategies. There can certainly be some overlap, but the emphasis is different. Rather than trying to change a troubling thought, belief or behavior, we become curious about the Part that holds that belief or produces that response. We ask what it is afraid of and what it is trying to protect.
For example, rather than challenging the thought, “They’re going to think I’m incompetent if I stutter,” we might become curious about the Part that believes this and ask the Part, “What are you afraid would happen if they thought that?” That often leads us somewhere much deeper.
So the changing environment isn’t something we necessarily need to fix — it provides information that can help us understand the person’s unique Stuttering System and what may be interfering with access to their natural speech.
Warmly,
Jorie
Hi Jorie, thank you so much for sharing your experience and insight! I really enjoyed reading your article and was particularly interested in what you shared about people who stutter and private speech. Understanding how an individual’s environment uniquely affects their experience with stuttering is crucial to creating individualized therapy approaches for our clients. With this approach in mind, I was wondering what a first therapy session may look like when asking a client about their natural speech moments. In addition, which parts of this approach would change when working with children/teenagers compared to adults, or do you believe that the majority of the therapy would remain similar?
Hi Olivia,
These are great questions!
Before we begin working together, I ask whether there are times when the person speaks with ease. So far, everyone I’ve asked has said yes—when they’re alone—and most identify other situations as well, along with “good days” and “bad days.”
I explain that I use Internal Family Systems (IFS) and John Harrison’s Stuttering Hexagon to guide our work. We’re going to become curious about how their unique Stuttering System works rather than simply trying to change their speech. Their Stuttering System Parts (SSPs) have reasons for doing what they do, and our job is to get to know and understand them. At the same time, we become curious about the person who already speaks with ease—their True Self—and help them recognize and trust that part of themselves too. You can also see my response to mshundo a few questions before yours for more about this.
In the first session, I often review their OASES responses and scores, which I use to establish a baseline. I answer questions about what they noticed and follow up on areas that caught my attention. Honestly, I usually don’t spend a great deal of time doing this because what matters most to the client tends to emerge naturally.
For example, someone may come in after a difficult meeting at work. Rather than starting with a predetermined target, we might explore what happened before it was their turn to speak: What were they feeling? What were they afraid might happen? What Parts showed up? Did they plan words, push through blocks, avoid speaking—or perhaps avoid the meeting altogether by calling in sick? That one experience can give us a wonderful window into how their individual Stuttering System works.
I treat teenagers very much as I treat adults. With younger children, the underlying ideas are similar, but I make them much more concrete and playful.
I use child-friendly pictures, preferably connected to the child’s interests, to represent the “Real Me” and different Parts. Real Me Energy includes the IFS qualities of compassion, creativity, curiosity, confidence, courage, calm, connectedness and clarity, as well as presence, persistence, perspective, playfulness and patience. I also talk about qualities such as love, openness and trust.
We use pictures for Parts with big feelings too—anger, frustration, sadness, fear, etc. The movie Inside Out provides a wonderful analogy that many children immediately understand: different Parts can have very different feelings and ideas about what needs to happen, while all of them belong to the same person. Children especially seem to relate to Anger! Interestingly, there is a real connection between the IFS community and Pixar around Inside Out, and IFS trainer Frank Anderson has described working with Pixar. The movie’s portrayal of different inner characters makes the concept of Parts very accessible to children.
So I would say the heart of the work remains quite similar across ages: curiosity rather than judgment, understanding rather than trying to eliminate Parts, and helping the person become increasingly familiar with both their Stuttering System and the “Real Me” who is much more than their stuttering.
Warmly,
Jorie
Hi Jorie. My name is Jacqueline thank you so much for sharing your personal experiences and truly enjoyed reading your article. I was very intrigued how you discussed about when the PWS is speaking at home with no one around them, they are speaking freely and is unique and authentically to them. My question to you is, how can SLPs help people who stutter recognize and trust their ability to speak naturally without creating pressure to achieve fluency? I would love to get your perspective given that most clinicians are aware of their well-being and want to provide support for the client. Thank you so much for taking the time to post your research article and I hope I get to hear from you! Thank you so much!
Hi Jacqueline,
Thank you for your thoughtful question! I especially appreciate your concern about helping PWS recognize their natural speech without creating pressure to be fluent.
For me, the goal is never fluency, and we don’t focus on trying to reproduce the speech they have when they’re alone. Their natural speech moments simply provide important information: they show us that the capacity to speak with ease is already there.
The therapy itself is much more about discovering who they are. Using Internal Family Systems (IFS), we help clients become familiar with their True Self Energy—the qualities of calm, curiosity, confidence, connection, playfulness, compassion and openness that are already within them. We also get to know their Stuttering System Parts (SSPs), including the Parts that anticipate, avoid, push, monitor, fear judgment, or criticize them after they stutter.
The important shift is in identity. Rather than seeing themselves as “a stutterer” who occasionally gets lucky and speaks fluently, they begin to recognize that they are much more than their stuttering. They have Parts that have learned to respond protectively in certain situations, but those Parts are not the whole person.
So we’re not asking, “How can I make myself speak the way I do when I’m alone?” That could easily create another kind of pressure and another Part trying very hard to produce fluent speech.
Instead, we’re asking, “Who am I underneath all of this? What are my Parts afraid of? What are they trying to protect? And what is it like when I am connected to my True Self Energy?”
As clients get to know and understand both their True Self and their SSPs, they can begin to identify less with their stuttering and more with who they truly are. Their speech changes as that happens, but we aren’t trying to make the speech change.
We’re getting to know the person—not trying to fix their speech.
Thank you for giving me the opportunity to make that distinction!
All the best,
Jorie
Jorie, thank you for channeling your experience and research into what seems to me like a new phase of how we understand stuttering. It seems that SLPs have always understood that fear plays a part in stuttering, but we are putting it closer under a microscope and developing a nuanced understanding of how anticipated reactions and context affect fluency. I am an SLP graduate student, and while I call myself a person who stutters, I am mostly fluent around people except for those closest to me socially, so reading this also feels validating and helps me understand my own experience.
Hi Trevor,
Thank you so much for this thoughtful response. It means a great deal to me, especially because you bring the perspectives of both an SLP graduate student and a person who stutters. You have walked in these shoes, and I appreciate your openness to looking at stuttering through a different lens.
I was particularly struck by what you shared about being mostly fluent around people, yet stuttering more with those closest to you socially. What an interesting and important clue to understanding your unique Stuttering System and its Parts! Your ability to speak hasn’t changed, but something about the context has. Rather than viewing that variability as puzzling or incidental, I would become very curious about it.
Your experience also reminds us not to assume that greater familiarity or closeness necessarily means easier speech. What may appear from the outside to be a “safe” speaking situation doesn’t tell us what is happening on the inside for any particular person. That’s why I think each person’s individual pattern deserves our curiosity rather than our assumptions.
What is different for you in those moments? What are you feeling, anticipating or perceiving? What kinds of messages, voices or beliefs are arising? What might your Stuttering System be responding to? I wouldn’t presume to know the answers—the answers are yours to discover.
This is one of the ideas I most hope readers take from my paper: variability is information. Instead of asking only, “Why am I stuttering here?” we can become equally curious about, “Why am I speaking without stuttering there?” Both experiences can teach us something about how an individual’s unique Stuttering System works.
As someone entering our profession who also knows the experience of stuttering from the inside, I hope you will hold onto that curiosity. Thank you for sharing part of your own experience and for being so open to exploring these questions with me.
Expect the best,
Jorie
Hi Jorie,
I appreciate this perspective. It reminds me quite of bit of Wendell Johnson’s and Dean Williams’ work at the University of Iowa. Williams called it the Normal Talking Approach, drawing client’s attention o what they were doing when they were not stuttering.
I very much agree with your sentiment that, “Teaching PWS to deliberately change articulation, rate, airflow, voicing, prosody or other speech parameters directs attention back to how they are speaking. But this is precisely what they are not doing during natural speech moments….They are not managing speech production. They are simply speaking.” My work you cited on spontaneity suggests that when people who stutter reduce attempts to control stuttering and let themselves openly stutter, they often experience more subjectively enjoyable speech.
A place we may disagree, is that I don’t see spontaneous speech as always fluent or a sure path to fluency. Anecdotally, it seems likely that the less explicit control we use to produce speech, the less frequently we stutter and the less intense the stutters are when occur. However, even when speaking freely and comfortably, many people who stutter still produce disfluencies. I do not think explicit attentional control of speech causes stuttering, but I do think it makes it more difficult.
I agree that the outcome of therapy ought to be less explicit attentional control of speech. I am skeptical that this will result in speakers no longer stuttering.
Sincerely,
Christopher Constantino
Hi Chris,
Thank you so much for taking the time not only to read my paper, but to share such a thoughtful response here. I am familiar with the work of Wendell Johnson and Dean Williams, and they certainly have contributed to my way of thinking.
I think we actually agree on more than may be apparent. I am not suggesting that reducing explicit attentional control of speech will cause someone to stop stuttering, nor that spontaneous speech must be free of stuttering. I agree that a person can speak spontaneously, openly and comfortably and still stutter. From an IFS perspective, I understand moments of stuttering as involving subconscious protective Parts that affect the speaker’s speech system.
Where I may not have explained myself clearly enough is that I am not trying to reduce attention to speech as a technique for producing fluency—that would simply add another unnecessary speaking technique. I am interested in why the same person speaks without stuttering in some contexts and stutters in others. I see stuttering as contextual, both internally—what is happening physiologically, emotionally and intentionally—and externally, including the situation, listener and what the person perceives or believes about them.
Through IFS/Parts Work, we become curious about what is happening within that person’s unique Stuttering System—what Stuttering System Parts (SSPs) are anticipating, fearing, monitoring, avoiding, managing or protecting. As their underlying fears are understood and resolved, the Parts have less need to protect, allowing greater access to the person’s True or Authentic Self—what IFS calls Self Energy. That, rather than fluency, is the goal. As protective Parts relax, monitoring decreases and spontaneity increases. In my clinical experience, speaking with ease increasingly emerges as a natural byproduct rather than something the person is trying to produce.
SSPs are trying to protect the person from perceived harm. Their intentions are protective, even when their strategies—fear, avoidance, word substitution, blocking, tension, panic or other responses—are unwanted and ineffective. When someone is “blended” with an SSP, its fears and beliefs feel completely like their own. As those fears are understood and resolved, clients increasingly experience these as Parts rather than as who they are. Over time, they begin to identify less as “a stutterer” and more as the person who already knows how to speak with ease and who also has protective Parts that may become activated at times.
So perhaps our difference is less about whether someone can speak freely and comfortably and still produce disfluencies—I agree that they can—and more about what we might learn from the contextual variability in whether stuttering occurs at all, and the importance of studying and working with that information.
That leads to a research question I would genuinely love your thoughts about. I am very curious about people who report having stopped stuttering during adolescence or adulthood. What changed, and are there common patterns in their experiences? I don’t think this population has received nearly enough attention. Would studying them be of interest to you?
Thank you again, Chris. I greatly value the opportunity to have this conversation with you.
Warmly,
Jorie
Hi Joeri
You gave me lots of thoughts. As a PWS I’ve had different kinds of therapy. They all focussed on my speech, on my breathing. They all made me focus on how I spoke. So I did too. This resulted in fear, shame, and even body shame, feeling I was a failure, as people told me what to do and I couldn’t do that.
I got a job. And another. And another. And also got headhunted for most of my jobs. They heard my speech, stopped for a moment, asked me about my skills and personality, and decided I was what they were looking for. As a teacher, same thing with my students. Within the stuttering community, all focus whas on me, my personality, the words coming out of my mouth, my friendship, my hugs. We have a group of PWS practicing public speaking. No focus on stuttering or breathing, but focus on voice, communication, and most of all, having fun talking! All of this made me stutter less, trust my capability to communicate, and to love talking.
Now I’m not saying you’re wrong. I’m just sharing my own personal shades, saying that my life was one big shade, but I learned that I myself turned on the light when I stopped focusing on my stutter. It took me so many years of pain, body awareness, people telling me to focus. I don’t want to focus. I want to talk. Talking naturally. Which, for me, is talking with a stutter. I stutter. It’s the way i speak.
Keep them talking
Anita
Hi Anita,
Thank you for sharing your experience so openly. What especially resonates with me is, “I don’t want to focus. I want to talk.” Yes! That’s exactly what I want for my clients too.
People who don’t stutter generally don’t have to consciously manage how they produce their speech—they simply talk. I want the same freedom for my clients. When they notice a Part directing them to monitor or manage their speech, we become curious about why that Part feels it needs to do that. As it begins to trust that there is enough True Self Energy present, it can “stand down” and allow the person to simply talk—freely and spontaneously, without having to manage how the words come out.
And I want to be very clear about something else you said. If talking naturally for you means talking with a stutter, and you feel comfortable, authentic and free communicating while stuttering, I fully support your choice. There are many different ways of finding greater freedom in speaking, and what feels right for one person may not be what another person wants.
I also want to thank you personally, Anita, and the entire ISAD team for continuing to create this remarkable space for the stuttering community. I’m especially grateful that perspectives like mine can be welcomed into the conversation even when they challenge prevailing ideas or when others may disagree. That openness is what allows all of us to listen, question, learn from one another and keep moving the conversation forward.
And I love your closing words: Keep them talking!
Thank you for helping all of us do exactly that.
Keep being open,
Jorie
Thank you, for your reply, Jorie. Yes, we’ve had some submissions this year we knew would be controversial. But that’s what this year’s theme was all about. Different shades, both from PWS/PWC and from clinicians. Thank you for sharing yours.