Several weeks ago I started a 3 part series in which I talked about whose fault it is that so many people who stutter are disappointed and dissatisfied with their treatment experiences. In part 1, I discussed that the approaches for treating stuttering need to be revised. In part 2, I talked about the inability of professionals to change the paradigms that they were taught and trained to believe are the best that can be. Today I am focusing on the people who are being treated, the people who stutter.
First I want to say that I strongly believe that everyone who comes to therapy wants to “get rid of the stuttering”. Furthermore, I think that most clients put their trust in their clinician and are willing to work hard to become fluent speakers. To some extent, while they are doing their absolute best to do what the clinician asks of them, it is this trust that is part of the problem. I believe that there are some clients who need to take a more proactive role in the therapy process. When they are asked to use a technique, they need to question how it is meant to help. Also, if they have honestly tried to do what was asked of them and found it to effortful or difficult to do, they have the responsibility to say that the technique is not working for them and, together with the clinician, explore where the problem lies.
Speech is one of the neurophysiologic systems of the human body that is meant to work automatically. It should not be an effort to speak. If it is an effort, something is wrong. Clients should not accept directives and goals that add layers of cumbersome controls. Clients who come to therapy without questioning what is being asked of them are at fault when they don’t get what they want.
It is very understandable that clients need to be encouraged to investigate the logic behind what they are being asked to do. This is why Dynamic Stuttering Therapy explains the process of normal speech production and is so centered on self exploration. I don’t want clients to do something because I say so; I want them to do what makes sense to them. Some clients do begin therapy thinking that I can make them fluent without their help. They do not want to be bothered with the details. Explanations and discussions are of little interest. During the initial intake it is normal to want to know results of therapy. However, during therapy clients who continue to believe that change comes by osmosis do not make the change that is necessary for a successful therapy experience.
Clients who expect that therapy is a quick fix cause their own disappointment. Therapy is a process of self-change. To be honest, speaking naturally is not a difficult process to learn. However, learning the process is only part of what therapy entails. I sometimes see clients who after 3-4 hours of treatment begin speaking with a degree of ease and fluency that is unfamiliar to them, even during their more fluent moments. In their joy, they expect to go off into their lives and their speech will remain fluent. This expectation is unrealistic. Developing a normal speech production system requires developing or at least strengthening the specific neurological network that results in fluent speech. This can only be done, with intention, mindfulness and repetitive experience.
I have discussed the three factors that are at fault for the failure of therapy to bring the understandably desired results. At the same time, I have touched on how these three factors can improve the situation. The poor outcomes that are traditionally associated with stuttering therapy need not be allowed to perpetuate. Open minds on the part of clinicians and clients will enable more people who stutter experience effective treatment and the ability to speak with ease and fluency.