Because people who stutter tend to feel the fears or anxieties that contribute to their blocking in the muscles that control breathing and speaking, I propose that blocking is similar in structure to panic and anxiety attacks. This means that the treatment could also be similar because emotions have become expressed in the body.
Over the years of doing therapy, I have asked hundreds of clients, “Where in your body do you feel that negative emotion?” Usually the PWS who feels a negative emotion can pinpoint the area of the body where they feel that emotion. There have been very few instances when the person was unable to tell me exactly where they felt it. Check this for yourself. Think of something you fear or recall a recent emotional hurt. Then notice where in your body that emotion finds expression.
For people who block, negative emotions are typically centered within the chest, neck and/or jaw. Ask a person who blocks:
Which emotions have you associated with your blocking?
Where in your body do you feel these emotions?
Where in you body do you feel the fear and anxiety as you anticipate the possibility of blocking?
What do you think about these feelings?
As these feelings diminish, the blocking and stuttering also lessen and the person becomes more fluent.
Not every client accepts that their emotions are created – a product of thought – rather than real. “But, Dr Bob, I ‘feel’ that anxiety in my body and if I feel it, it must be real!” That is the normal response: if I feel it, it is real. For the PWS, the emotions around blocking and stuttering are more real than that for they have the strong physiological response associated with blocking and stuttering. So no wonder many in the speech pathology profession believe that stuttering is a physical problem. It is so real: “Just look at my facial contortions when I block.”
CASE STUDY 2
John Harrison, a person who stuttered and who recovered, is the former editor of the National Stuttering Association’s newsletter, Letting GO. In his article, “Anatomy of a Block” (Harrison, 1999) he exquisitely illustrates how a person feels a total loss of power and resourcefulness especially during blocking. John has graciously given me permission to share his article with you. The first part of his article reproduced here:
One day back in the spring of 1982 I walked into a camera shop on 24th street near where I live in San Francisco to pick up some prints. The clerk, a pretty young girl, was at the other end of the counter, and when I came in, she strolled over to wait on me.
“What’s your name?” she asked.
That question used to throw me into a panic, because I always blocked on my name. Always. But by 1982 stuttering was no longer an issue. I never thought about it. I liked talking to people, and never worried about speech, because my blocks had all but disappeared.
I started to say “Harrison”, and suddenly found myself in a panic. I was locked up and totally blocked. All the old, familiar feelings had come back. I could feel my heart pounding. So I stopped, took a breath, allowed myself to settle down, and, while the woman stared at me, collected myself enough to say “Harrison.”
I walked out of the store with my prints, feeling frazzled and totally mystified. Where in the world had that block come from? Why had I suddenly fallen into the old pattern? Stuttering was the furthest thing from my mind when I walked in. I never thought about stuttering any more, because it never happened, so I knew it wasn’t a fear of stuttering that caused me to block. At that point I did what I had always done in previous years when stuttering was a problem. I began playing the event over and over in my mind, trying to notice as much detail as possible to see if I could spot any clues, something that would explain what was going on.
“Where was the woman when I walked in?” I asked myself.
Let’s see. I pictured the layout of the store. I had come in and stood at the cash register. The woman was at the other end of the counter talking to someone.
“Who was the other person? Anything significant in that?”
It was a guy.
“And what did he look like?” Hmmm. Oh yeah, he was a biker. Tough looking. Had tattoos on his arms and was wearing a Levi’s vest.
“What else did you notice?”
Well, the two of them seemed to like talking to each other. The guy appeared very much taken with the girl.
“How did he seem to you?”
Scary looking. Reminded me of the tough guys on the block when I was a kid. I remember those guys. They lived in the next town. They all had mean looking eyes, and they petrified me.
“How did you respond to people like him when you were a kid?”
Well, if I were on the street when several tough guys passed by, I would make myself invisible so they couldn’t see me and hassle me. I’d suck all my energy in. I’d blend into the background. I’d look like a tree, or a bush, or a brick wall. No energy would radiate from me until they had passed. Nothing.
“Did you have any other feelings or observations about the biker in the store?”
I guess I felt like I’d interrupted an important conversation, because the two of them were getting on so well together.
“How did that make you feel?”
I reviewed the scene once more, trying to recall how I felt. How did I feel? I really concentrated, and a malaise swept across me. Then it came to me. I was worried that he’d be irked because the girl had left him to wait on me.
“So what was your response in such situations when you were a kid?”
I’d hold back. I didn’t want to stand out. I didn’t want to seem too strong or too assertive.
“Because ….”
Because it would put me in danger. The guy might give me trouble, so I didn’t want him to “see” me.
“So in the camera store you ….”
Right. I slipped back into the old program. I held back. I blocked my energy. I tried to make myself invisible, just like in the old days.
Here John clearly explains from a personal standpoint how something can trigger an old memory that mentally and emotionally sent him back to his childhood. Ceasing being an adult with adult resources, John says, “The memories triggered a fight or flight reaction that I managed by holding back (blocking) my feelings and pushing the thoughts out of awareness.”
No longer responding as an adult, John responded out of those old childhood memories of powerlessness. When in the presence of that tough looking biker, John unconsciously flew back in time and regressed into the kid who was petrified by the “tough guys on the block.” So John the grown man became as powerless as a little kid confronted by bullies.
Because people operate from their perception of reality, which is based on their unique way of making meaning of the world, then the strategies they have for intervening in the world in order to change it will depend upon what they think is possible.
Emotions
Evaluating your experience often produces some kind of emotional response. For example, you may become angry that you are stuck, and that you are unable to do anything. Being angry does not help; it is what you are now feeling, and your emotions tend to permeate your whole being. Emotions are related to your judgments and values. When you evaluate your experience as good, you experience positive emotions. If, on the other hand, your experience of the world does not validate your expectations, values, dreams and desires, you tend to experience negative emotions such as frustration, anger, and resentment.
In their early years children expect love and acceptance from the significant people around them, but often find that they are rejected for whatever reason. Actually, being rejected is inevitable; it is part of growing up. You cannot depend on others forever; at some point you have to make your own way in the world. It therefore matters how you learn to deal with rejection. Fluent communication requires a great deal of practice. There are many times in the early years when children are learning to speak when they stumble and stutter as they express themselves. If the PWS learns to associate rejection from other
s with a particular behaviour – their blocking and stuttering – then the emotions surrounding that become dominant, and the child pays more and more attention to the way they are speaking. What would happen to their speech if the PWS refused to generate these negative emotions? Well, they could get on and practice their speaking skills, knowing that they will learn from their failures – as they would in other areas of their lives. That’s what growing up is about.
Because you create your emotions based on an evaluation of your experience of the world at any given moment, your emotions are only accurate for that moment. You had an experience; you either got what you expected and felt good about it, or your expectations were frustrated and you felt bad about it. However, when the emotions from one experience color other experiences youmay be generalizing inappropriately. For instance, if as a child their peers teased them for blocking and stuttering, the PWS may have then evaluated that as a hurtful and judged their peers as spiteful. This leads to poor relationships and ineffective communication in the future.When the PWS is teased in adulthood – because that’s what some adults do – it reminds them of their earlier experiences of being made fun of, and triggers the same emotional response. In this way, they amalgamate all the meanings and judgments associated with their present and their past, and they make unchecked assumptions about the other person’s intentions. They engage in a form of mind-reading: assuming they know what another person is thinking. The PWS frequently mind-reads other people as judging them because they stutter. In other words, the PWS relies on their own fantasies, pays attention only to their own thoughts, rather than putting their attention on the outside world and checking out their ideas with those other people.
Unconscious competence
You probably know how to drive a car, play tennis, ride a bicycle, send an email. Every skills becomes, so to speak, grooved into your muscles through repetition. You have neural pathways for changing gear, for serving at tennis, for using a keyboard. Each skill engages a different set of muscles. It is also the case that your level of skill in each activity will depend to some extent on your mental state, your level of commitment or concentration, the degree to which you are thinking about what you are doing and so on. With practice, many such skills become automatic, and you do them without thinking. Indeed, when you are faced with returning a high velocity tennis ball you don’t have time to think. You trust your muscles have been sufficiently grooved through practice so that you can continue the volley.
The PWS has not only learned how to block, they have also learned how to be fluent, and both activities they perform automatically. As with playing tennis, they have separate neural pathways for engaging with others and for managing their state. They respond differently according to the situation. While alone or speaking to someone with whom they are comfortable, the neural pathway for fluency is activated. However, when the context triggers fear and anxiety, the neural pathway for blocking is triggered. In both cases they have options; both neural pathways are there, but only one is active.
Your state ofmind affects your behavior. During the day you experience many states, both highs and lows, pro-active and re-active. When blocking, the PWS’s state of mind tends towards re-active fear and anxiety. But in fluency they have pro-active states of mind built on calmness, trust, and curiosity, and they focus more on what they are communicating to others rather than how they are performing. Fluency states are more likely to produce enjoyment and the feeling of empowerment. Therefore the aim is to lead the PWS to change their responses so that they automatically and habitually activate the fluency response in all situations. One way of doing this is through reframing – transforming the meaning of the situation (see Chapter Six) – so that the PWS comes to minimize those frames of meaning that have “locked in the block”. However, this requires repeated practice. There is no magic cure. For fluency to become the PWS’s natural way of being, they will have to make many changes in both body and mind.
Freezing
Like all muscles, [the diaphragm] tends to contract as a response to fear. Unfortunately, the diaphragm needs to relax in order to speak. You have two powerful forces trying to move the diaphragm in opposite directions. You have the natural response to fear contracting the diaphragm and drawing air in. Then you have your own desire to speak trying to relax the diaphragm so that air can move over the vocal cords. The result is what?Afrozen diaphragm, of course.
McGuire 2002: 21
Emotions such as fear profoundly affect the entire body-mind system. The fight or flight mechanism pumps adrenalin into the body for increased muscle power so that the person can run away or defend their ground. However, another response is that the person freezes to the spot. They describe themselves as being like a deer looking into the headlights. Even though the fight or flight response has been activated, all action is inhibited: they believe they have no options for action open to them. Their speaking also freezes.
Because they are no longer doing anything, this freeze-state can become associated with how they are thinking about their condition, with the judgments they are making about their own (lack of) performance and with the doom-laden consequences of being frozen or blocked in this way: “I can’t get out of this! I’m going to be blocking for the rest of my life!” That reinforces their self-evaluation that: “There is something wrong with me.” Instead of paying attention to the outside world, they are focusing on their inner thoughts, feelings, and imaginings. They are relating to themselves rather than to the other person, and shutting out potentially useful information from the world around them.
There is an alternative. Being frozen gives them time to choose some resourceful states and apply those to themselves (which I call meta-stating). There is a general sense that “the good guys win” when it comes to states. By immersing yourself in a positive, supportive and resourceful state, it will dominate the fear and anxiety and suppress or even eliminate them. What happens when you apply faith or courage to fear? (See Chapter Three.) One of the key factors in learning how to run your own mind is in managing your own states. You are teaching your body to activate life enhancing states more often so that your response to any internal or external trigger will be desirable.
Childhood needs
Blocking served some vital childhood need. It is highly probable that that need is no longer relevant, but you still need to check. If the need is still current, then find out from the PWS what it does for them, so that they can find alternative ways of meeting it. Susan (Case Study 1) went on to say:
Today, when doing my journaling about life, something came up about stuttering. In fact, I even drew some pictures to express my feelings. I was journaling about how my stuttering is keeping me from where I want to go with my business. I actually drew a cage and put myself in it. When I am in the cage I think the following:
Oh, I stutter, I can’t do that.
Oh that is too big for me. Oh, wait a minute, I have to be fluent for that.
Oh, I can’t function in the business world; they will laugh at my stuttering.
I can’t handle success, it is too much.
Then I also drew several blue circles around my body, like a mummy would be taped up. I called it my stutter suit. I put this on when I am scared. When I have my stutter suit on I think the following thoughts:
I am protected.
No one can hurt me.
I am protected from all those possibilities of the unknown.”
I can control my blocking.
[Italics added. See also Alan’s story in Case Study 7]
Why would anybody want to stutter? How in the world can anybody get any kind of gain out of stuttering? And yet when you ask people how they benefit – “What do you get out of blocking?” – they give meaningful answers. In other words, blocking has to provide some benefit or else the person wouldn’t do it! It is therapeutically useful to assume that every behavior has a positive intention, that people do things because in their model of the world there is some positive
or beneficial outcome for them. For example, if you elicit the positive intention for blocking, you discover that at a younger age it provided protection, attention, a sense of control, or revenge – which are probably no longer appropriate in their adult life.
With problematic behaviors like blocking and stuttering, the present behavior provides little that is positive for the person. You often have to look back to the origins of the behavior to find its positive intent at that time. At its inception the stuttering provided a solution to the problem the person was experiencing then. It changed the meaning of the situation and reduced the negative emotions being generated. The four positive intentions which I have encountered most frequently are that blocking and stuttering:
Protect me from being hurt.
Get me attention, make people notice me.
Provide the PWS a sense of having some control: “I cannot control this sick family but I can control my speech. I will block.”
Provide a way to “get back” at parents, teachers, therapists or peers.
CASE STUDY 3
Josh grew up in the home where neither parents knew how to give and receive love. Josh’s mother would reach out to him pretending to provide him with love and encouragement, but when Josh responded she would push him away. He queried, “How do I please her without being ridiculed, hit, or put in the corner?”
Later Josh spoke to his father about this. His father confirmed that when Josh was a small toddler his mother would indeed ridicule him, hit him, and put him in the corner of the room. This behavior of Josh’s mother created intense fear, insecurity and anger in him. All of these emotions became associated with his blocking and stuttering. I asked Josh to re-experience that intense fear, insecurity and anger. I then inquired of Josh the purpose for his stuttering. He immediately responded, “Stuttering is a way for me to strike back at the bitch. I want to make it frustrating and uncomfortable for her.”
I Have a Voice Page 3