What
causes stuttering?
Intersubjective relations in
which the speech pattern of one subject is stigmatized for another,
generating imaginary conditions for constituting a stigmatized
image as a speaker. Once configured, such image sustains what
has been described as the essence of stuttering.
What is the essence of stuttering?
A subjective state of anxiety
and/or fear of producing speech which is frequently followed by
the anticipation (and likely visualization) of sounds (letters
of the alphabet) or words perceived as problematic, unpronounceable.
What determines
the intensity and the sevetity of stutterig?
The frequency with which the
state defined as essential is present in the subjective configuration
of a person in communication situations, generating a tensioning
effect on one or several muscle groups involved in producing speech,
thus, materialized as a block and hesitation and/or generating
word switching and/or generating frequent silencing.
Stuttering can be prevented?
Yes, starting from the social
enlightenment on the effects that stigmatizing intersubjective
relations may generate.
Are all the stutterers equal?
Evidently that, as people,
it would be inconceivable to state that they are all the same,
however, from the point of view of subjective functioning described
above, a profound regularity is found among people who stutters.
Is stuttering an emotional problem?
According to our knowledge,
stuttering is a consequence of a subjective process marked by
a self-image of bad speaker. By considering itself as a bad speaker
(a stuttering speaker), the person tries to control its speaking
fluency. As the speaking production is, in fact, an automatic
activity, trying to control the speech turns the process into
something tense that generates a rupture in its flow. This subjective
process corresponds to the proposal of the American author Joseph
Sheehan: he has detected in stuttering a conflict of approach
and avoidance. In other words, the person wants to speak (approach),
but by considering itself a bad speaker, wants to control this
speech to avoid stuttering (avoidance). In this sense we can say
that the production of a stuttered speech involves an emotional
conflict, but this is not the same as affirming that stuttering
is an emotional problem..
Can stuttering be cured?
If stuttering is, as we propose,
a consequence of a subjective process marked by the image of bad
speaker, then we can affirm that, yes, it can be cured. It depends
on the possibility of generating a self-image of good speaker
and by doing so modify the subjective process.
Who
cares for stuttering: the phonoaudiologist or the psychologist?
To help stutterers in an effective
way, the professional – whatever it might be – must be specialized
in studies concerning the problem. By being a speech problem,
it is much more related to the phonoaudiologic area and to its
object of research. Today, there are an increasing number of studies
in this area, as well as the concern in a proficiency of the phonoaudiologist.
This expertise requires knowledge of Biology, Linguistics and
Psychology because stuttering is a complex problem and understanding
it requires proficiency at least in these three areas.
How
do you diagnose stuttering?
According to the approach here
encompassed, the therapist looks after identifying if the following
aspects exist:
1. an established image of bad speaker;
2. the image of bad speaker in development;
3. an absent image of bad speaker.
To do so, the therapist listens to the patient’s description (history)
about his/her speech (experiences, feelings, sensations, strategies
to speak) observing, at the same time, the body language and the
way of producing the speech. If the subject is a child, the parents
give this explanation, and the therapist observes the way these
parents relate to the child, the way that the speech is produced
between themselves, the child’s body and his/her way of producing
the speech.
At
what age should the parents look after therapy to a stuttering
child?
According to our point of view,
stuttering might be established from the moment that people (parents,
grandparents, teachers and the speaker itself) interpret a child’s
speech disfluencies as stuttering. It is precisely this interpretation
that can lead the child into constituting the image of bad speaker
and, as a consequence, try to control the fluency of the speech,
leading to the problem of willing to control something that is
automatic. In this case, parents should look for a therapist specialized
in problems of fluency as soon as they consider the child’s speech
as stuttering. The therapist will help them understand all the
biological and psychological process involved in the production
of speech and why the child is disfluent.
In the book “The Construction of the Good Speaker Character” you
briefly mention the benefits of Yoga Nidra in treating stuttering.
Could you develop this subject a bit further – about Yoga - so
that more people can also benefit from this information? How important
is it in treating stuttering? Which is the difference between
this and other types of Yoga?
Let
me start with your last question – the matter is not about considering
differences between Yoga Nidra and other Yoga, since Yoga Nidra
is a part of Yoga in general that is related to the disengagement
of the senses. To explain what this means let’s begin by considering
that Yoga is union.
Different aspects can approach this concept of union.
To the matter here required we are focusing the union between
body and mind through conscience (considering mind as feelings
and thoughts). To come into contact with this union, Yoga Nidra
proposes the conscientiousness of the body to the practitioner,
part by part, in a deep relaxation of each part; the conscientiousness
of breathing that becomes free, smooth and harmonious until inhaling
and exhaling seem to be a single continuous movement; the conscientiousness
of what goes through the mind – feelings, thoughts and images
– not allowing to be dragged by them but, instead, remaining empty,
still minded (if remaining still minded is not possible, lead
the mind in being aware of the breathing rhythm). All types of
Yoga work with the practise of Yoga Nidra.
The importance of Yoga Nidra in treating stuttering
can be understood if we consider that the speaker that stutters
– marked by a stigmatized image of himself – has the discursive
function stimulated by the desire of controlling the flow of the
speech. But the speech flow, as a mater of fact, cannot be controlled.
It is a consequence of the meaning that is being built during
the discourse in such way that a word “draws” another and they
slide from the mouth – so to speak. Producing words is automatic
and spontaneous. In other words, we know how to speak, but do
not know the way we do it. To fulfil the desired control, the
speaker begins to predict where the stuttering will show up (appear
/ emerge). Usually the prediction of this placing is unconscious
- the person just feels that stuttering will happen, knows that
will stutter – and is chased by the firm sensation that will certainly
stutter.
By conducting speaking experiences lived during a
Yoga Nira practice I help patients in becoming conscious of the
way their mind works when producing speech and stuttering. They
begin to realize and recognize in themselves the moments in which
their speech flows free of any control, and when they speak anticipating
the place of stuttering. This (The Yoga Nidra practice) allows
them to see / feel the intense articulation between foreseeing
stuttering and stuck muscles (this articulation is very meaningful,
since stuttering is stigmatized and its anticipation could only
stuck the muscles in an attempt to restrain stuttering).
The continuity of this practice
(experiencing speech by practicing Yoga Nidra) allows patients
to slide away from their “mental prison” created by this ante
vision of stuttering, engage in ways to “dribble” it, and connect
with what is happening to their bodies. This is when they become
conscious that their muscles are stuck and this perception allows
loosing them.
That is why Yoga Nidra is a
technique that allows working, in therapeutic interaction, with
the conscientiousness of the relation body / mind either in the
production of a stuttering speech, or of a fluent speech and,
therefore, help patients to dislocate from the first to the latter.
Can
your therapy be applied to childrens well as to adults?
Yes, the therapeutic proposal applies to children
and adults because, in any case, it is always related to a pathway
that can deliver back to a person the confidence in its own capability
of speaking – a capability that is destroyed in communication
liaisons that interpret disfluency as stuttering (taking into
consideration that stuttering is a socially stigmatized label
associated to speaking) – communication liaisons that do not deliver
to the speaker the liberty to speak naturally – in its own natural
way.
Is there
a difference in the treatment between chilfrens and adults?
There are differences between the treatment dedicated
to children and adults, because the method used to generate or
bring back confidence cannot be the same to adults and children.
Each age demands entirely different interactive methods and activities.
Moreover, as to disfluency in children, I usually work only with
their parents. If they change their way of facing disfluency,
if they accept the child as he/she is, this child will not build
a self image of bad speaker and, as a consequence, will not regard
stuttering as suffering. When the child already has the image
of bad speaker embedded in its subjectivity, I usually work with
both – parents and child – in order to simultaneously establish
that speaking involves fluency and disfluency, with no previous
measures of normality or pathology but, on the contrary, always
relating discursive contexts that are easier or more difficult
to the child depending on the singularity of this child.
Which
are the practice phases?
What I propose in my work cannot be applied to phases.
The principles that lead my work are already established above:
"to give back to the person the confidence in its own capability
of speaking". To achieve this goal the therapist needs to be aware
to the context, to the speeches produced in each therapeutic session,
to the biography of the patient that materializes in his/her speech,
to the way that communication liaisons are established with the
patient, to the way that communication liaisons are established
with the patient parents (concerning children), and how relations
are established between parents and their child. All these aspects
inspire the therapist actions and speeches that - thanks to a
wide range of linguistic and psychologic knowledge about body
and mind – are capable of establishing relations that lead the
person to confide in its own capacity of speaking.
What
role does the environment play in the patient's life?
My understanding is that what has been explained so
far clarifies the role of the environment to the patient, especially
when I comment about the loss of confidence in the capability
of speaking generated in communication relations that interpret
the disfluency as stuttering and that, on the other hand, leads
to the constitution of the image of bad speaker – embedded in
the root of the stuttering as suffering..
How
much time has to be dedicated to this treatment?
There is no specific timing indicated to the treatment.
All depends on the mental flexibility or stiffness of the people
involved in the situation. But, in the case of adults, in average
one year of treatment produces noteworthy changes. In children
that do not yet have the image of bad speaker rooted in them,
usually one session with their parents is sufficient. For those
that already have rooted in themselves the image of bad speaker
usually require a year of treatment – as adults do.
In how
many sessions can one perceive qualitative changes in the patient?
The
number of sessions that allow observing qualitative changes vary
according to the effects produced in the patient by the therapist's
speech and the recommended exercises. It can be weeks or months.
But I do always observe significant qualitative changes in the
period of one year.
