Home Advocacy Balancing the Polarity of Stuttering Treatment With Client Goals

Balancing the Polarity of Stuttering Treatment With Client Goals

by Ana Paula Mumy
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Female feet in sneakers walking on a narrow board above a large pit. Low-angle shooting, close-up.

I recently sat in a discussion group with two fluency experts, a handful of speech-language pathologists and parents of people who stutter. Part of our discussion—on the “opposites” inherent in the experience and treatment of stuttering—really struck me. As I pondered the notion of opposites, my mind went to physics and the concept of polarity—the presence of two opposite or contrasting tendencies.

For me, the clearest expression of polarity in stuttering involves the inner struggle between wanting to speak fluently and the opposing force of not achieving fluency. The more conscious control over speaking is attempted, the more the stuttering behaviors intensify.

In the award-winning film “When I Stutter,”  SLP Kevin Eldridge provides a good analogy for this concept: walking on a plank. If you walk across a plank on the ground, you don’t give much thought to the task of walking. The walking is effortless and relatively simple. If you raise the plank a few feet into the air and walk it, suddenly your body tenses at the increased risk, and the simple task of walking becomes the difficult task of trying not to fall.

In other words, the more people attempt to avoid stuttering, the more challenging speaking becomes.

So why does polarity matter in the treatment of stuttering? Polarity matters because many approaches still focus primarily on behavioral strategies and minimize the power of emotional and cognitive approaches. The message this sends to people who stutter is the idea that stuttering is bad and fluency is good. SLPs often get frustrated thinking our clients aren’t doing the work, and if only they used their strategies!

When I talk to my clients who stutter, however, many of them say the most important catalyst for positive change occurred when their own feelings and thinking about stuttering—and themselves—changed.

Their stuttering decreased when they no longer avoided talking, started openly stuttering, and focused on communicating effectively as opposed to fluency. They no longer walk to avoid falling. They simply walk. This may seem counterintuitive to those of us providing services for people who stutter; thus the polarity of stuttering!

One common thread my clients report in their experience of stuttering is shame. Brené Brown, a professor of social work and researcher, describes shame as the “intensely painful feeling or experience of believing that we are flawed and therefore unworthy of love and belonging.” She also states, “Shame is the fear of disconnection—it’s the fear that something we’ve done or failed to do, an ideal that we’ve not lived up to, or a goal that we’ve not accomplished makes us unworthy of connection.”

So how can we help our clients who stutter avoid feeling shame, which might stifle their progress? Help them accept vulnerability. To borrow again from Brown, “Vulnerability is about showing up and being seen. Vulnerability is the birthplace of innovation, creativity and change.”

In other words, in stuttering treatment, when shame underlies a client’s state of being, no amount of behavioral strategies will affect long-term change. Instead, my main role in facilitating change is guiding clients who stutter to “show up and be seen,” without reservation and fear, but with the absolute confidence they are worthy of love and connection, with or without stuttering.

How do you help your clients who stutter accept who they are and discard the stigma often associated with stuttering? Please share in the comment section below.

Ana Paula G. Mumy, MS, CCC-SLP, is a multilingual speech-language pathologist and a clinical assistant professor at the University of Kansas. She has extensive experience working with people with communication disorders. Her specialized interests include stuttering, articulation disorders, early language/literacy, and bilingualism. She is also an affiliate of ASHA Special Interest Group 4, Fluency and Fluency Disorders. anapaula_mumy@ku.edu

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Melissa Page Deutsch July 5, 2018 - 12:51 pm

Great article and perspective. I think we as communication disorders specialists play a huge role in seeing the whole person, not just the person’s diagnosis. The deep connections we make with our clients and the love we share enrich us all. Thank you for sharing this.

neeta September 19, 2018 - 5:43 am

Nice article on communication disorder and without communication human life stop.The article content in detail for speech disorder.I really appreciate your work.
Thank you providing me such content and helpful in future.

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