In part 1 of Whose Fault, I said that a major cause for the failure of stuttering treatment is a lack of knowledge of how to treat it. That is pretty amazing in the 21st century when so many advances have been made in the treatment of very complicated diseases, and innovative behavioral programs are abundant and often very successful. Our knowledge of biology, physiology, neurology, genetics, physics, and even human behavior has taken giant steps. However, mainstream stuttering therapy has remained pretty much the same, albeit with some refinements, for the past 80 years. We have learned a lot about the nature of stuttering from clinical observations and research, but this knowledge has not been incorporated in how stuttering is treated.
This leads me to what I believe is another major cause for the failure of treatment. There is a tendency on the part of professionals to become so rooted in a treatment approach or a theoretical belief about stuttering that they do not apply research findings and knowledge to treatment. Their prejudices and emotional investment in their work block them from being open to new ideas.
I recently searched for a title for a seminar that I will be presenting to clinicians. I chose Treating Stuttering With Confidence: A New and Logical Approach. “New” that word should no longer be appropriate. It has been almost 20 years since I gave my 1st presentation in Oxford, England in which I said that stuttering can be explained and treated through an understanding of the process of speaking. The presentation was well accepted, even though we still had so much to learn about the differences in brain function and motor processing of people who speak fluently and those who stutter. In spite of the initial enthusiasm of my colleagues, as the research backed my theories and as the clear-cut cause and effect relationship between internal processes used to produce speech and the fluency of the speech became apparent, I saw a growing resistance from my colleagues.
Interestingly, I found a correlation between clients, including young children, telling me this approach to therapy “rocks” and that Dynamic Stuttering Therapy is the most logical therapy they have ever had, and professionals telling me they don’t understand what I’m getting at or just being too busy to review my materials. I do not take this resistance personally, because I don’t think that it is related specifically to the approach or to me. I do think that the inability to change perspective stems from a very human condition – resistance to change.
While understandable, professionals are at fault for not overcoming this resistance. We ask our clients to put their feelings and beliefs into perspective and overcome their fear of the unknown. It is also our responsibility to do this. The time has come to let go of the arguments of whether clients should work on fluency or accept stuttering. Calling fluency the “f-word” as I have heard fluency experts do is not helpful. It is demagogic. The affiliation by professionals with a theoretical camp should to be abandoned. All voices should be heard and minds should be open. Professionals need to work together. We need to brainstorm. We need to put our heads together to make sense of stuttering and to insure that clients do not suffer disappointment from our efforts to treat them.
Some people who stutter that have had disappointing and frustrating therapy experiences are angry with clinicians in general. They think that clinicians are taking advantage of them and don’t care about them. In all my contacts with my colleagues, I have not seen that this is the case. I see that clinicians are concerned with their clients’ wellbeing and believe they are helping people by sticking to their belief. Nevertheless, the lack of progress and being closed to new ideas is hurting these clients who we care about. We, as professionals, owe it to our clients to make therapy the most rewarding experience possible. If not, it is our fault.