The Why and the How of Voluntary Stuttering

About the presenter: Peter Reitzes, MA, CCC-SLP, is an adult stutterer and an ASHA certified, New York State Licensed speech-language pathologist working in an elementary school and in private practice in Brooklyn, New York. Reitzes is the author of 50 Great Activities for School Age Children Who Stutter: Lessons, Insights, and Ideas for Therapy Success (PRO-ED) - expected publication date -2005. Reitzes has presented at speech-language pathology conferences and conventions including the American Speech-Language-Hearing Association's annual convention, The Speak Easy annual convention, and for Advance Magazine. Reitzes has facilitated workshops for FRIENDS: The National Association of Young People Who Stutter and the National Stuttering Association (NSA).

About the translator: I am Massimiliano Marchiori, I am 27 years old and I live in Villafranca of Verona (Italy). I am a psychologist and a person who stutters. I am at the beginning of my career and I intend on working on a regular basis in the area of stuttering, both therapy and research, because I am fascinated by this complex disorder. In June, 2005, I attended the two week Workshop for Specialists organized by the Stuttering Foundation of America at the University of Iowa.

The Why and the How of Voluntary Stuttering

by Peter Reitzes
from New York, USA

This paper is also available in Italian translated by Massimiliano Marchiori, ITALY and in Spanish translated by Astrid Fridriksson, South Carolina, USA

Voluntary stuttering is, from my personal experience, the single most productive speech tool or strategy at an adult stutterer's disposal. To put it simply, voluntary stuttering is the act of stuttering on purpose when speaking to another person. For example, a stutterer may enter into a speaking situation with a plan to voluntarily stutter on the very first words that he or she says. This is a powerful way to get stuttering immediately out into the open so that there is no reason to hide it. By stuttering on purpose early in the conversation, the speaker controls when and how his stuttering appears, thus preventing his fears of stuttering from dominating the situation.

Some stutterers, clinicians, and family members get upset at the mere mention of voluntary stuttering because it is counterintuitive. They frequently ask, "Why should someone stutter more when they want to stutter less?" Many are concerned with the emotional commitment that voluntary stuttering entails because it requires speakers to leave their comfort zones. As with any speaking strategy, the only way to know if voluntary stuttering will be productive is through repeated assignments and experimentation. It is not enough to stutter on purpose three or four times and declare the tool useful or useless. One needs to experiment with voluntary stuttering many times and in a variety of situations before a judgment of the tool's usefulness and utility may be safely made.

Stuttering on purpose targets a wide range of goals and objectives including:

1. Desensitization (reducing fear, building courage, and increasing the stutterer's ability to speak in challenging communicative situations).
2. Stuttering in an easy, forward-moving manner.
3. Increasing the ability of the speaker to listen and attend to what others are saying.
4. Demonstrating to others that stuttering is not shameful.
5. Reducing moments of stuttering.

Below, each stuttering on purpose goal is discussed and practice assignments are provided. These assignments should be viewed simply as examples of how to use voluntary stuttering and do not constitute a comprehensive list. Each person who stutters requires individualized goals following an individualized hierarchy.

1. Desensitization: Reducing the Fear of Stuttering -Many people who stutter attempt to hide and avoid their stuttering. For example, a stutterer who has grown to fear the letter "d" may edit out of her speech any words that begin with "d." By stuttering voluntarily, the speaker puts her stuttering immediately out in the open without attempting to hide or conceal it. Using the previous example, one way to reduce the speaker's fear of saying words that begin with "d" is by voluntarily stuttering in many situations on this feared sound.

It has been my experience that the more a person uses voluntary stuttering the more he or she begins to understand that stuttering is truly allowed. As one member of the Covert-S electronic mailing list explained, "[Voluntary stuttering] gives me a feeling that I am in control of my speech and when I really stutter it doesn't seem so bad" (Madsen, 2003, para. 6).

Voluntary stuttering is also a valuable tool for helping the speaker control the variable and unpredictable aspects of the disorder. People who stutter often feel that they have very little control over their speech and grow to view the absence of stuttering as "lucky fluency" (Breitenfeldt, 2003; Manning, 2000) and moments of stuttering as unlucky dysfluency. For example, it is exceedingly common for a person who stutters to find himself in speaking situations in which stuttering does not occur. During such situations, the speaker often becomes increasingly fearful of the moment that his stuttering may finally reveal itself. By stuttering on purpose towards the beginning of a conversation the speaker controls when his stuttering is first heard. Voluntary stuttering neutralizes the variable and intermittent nature of the disorder. The unpredictable is made predictable.

When using voluntary stuttering for desensitization purposes, the speaker should stutter in a clearly noticeable or "hard" manner so it is clear that he or she is a stutterer. In other words, the speaker should not "cheat" the situation by stuttering softly or in a subtle manner. The speaker may also consider using voluntary secondaries as well such as voluntary eye blinking and voluntary head movements.

Beginning in my twenties, I used voluntary stuttering on a daily basis for more than three years to reduce my fears of stuttering and to help me say the exact words I wanted to say. One of my personal goals was that every time I ordered food at a restaurant or deli or asked a question in a store, I would stutter on purpose. The more I used voluntary stuttering the less I feared stuttering.

One adult who had spent much of his life attempting to hide and conceal stuttering told me that voluntary stuttering was helping him to create a new and powerful "mental image" of himself (M. Marchiori, personal communication, June 24, 2005). He explained that by using voluntary stuttering over a period of months he began steadily replacing his self-image of a person hiding stuttering with a person stuttering confidently in a variety of situations: "I used to feel good only when I was fluent. By using voluntary stuttering I found that I am also a good person when I stutter."

Practice Assignments:
1A. Talk to a close friend or relative for five minutes and stutter on purpose at least five or more times in a clearly noticeable fashion (Example: "Mom, what tttttime are we all mmmmmeeting for dinner?"). Be sure and stutter several times towards the beginning of the conversation to put your stuttering immediately out in the open.
1B. Go to stores and local establishments and ask questions while stuttering on purpose.
1C. Talk to peers or co-workers while using voluntary stuttering.

2. Moving Forward Through Moments of Stuttering -Many stutterers and speech-language pathologists advocate a form of easy stuttering to initiate speech and to move smoothly through moments of stuttering. This is often referred to as stuttering modification. For example, during a stutter on a word such as "soda" the speaker may consciously attempt to move forward through the word by 'pulling-out'of the stutter (see Van Riper, 1973). One way to do this is to prolong the "s" and then gently initiate the "o" vowel to continue moving forward through the word.

By entering into a situation using gentle and easy voluntary stuttering, the speaker lays the groundwork for turning real and struggled moments of stuttering into smooth and forward-moving stutters. During stuttering moments, many speakers feel confused and unable to think (Carlisle, 1985; Starkweather & Givens-Ackerman, 1997; Van Riper, 1982). This state has been described as a type of "dissociation" (Heite, 2001; Starkweather & Givens, 2003) - meaning that people who stutter try to separate themselves from challenging and emotionally charged speaking situations. Similarly, it has also been noted that speech tools and strategies are the hardest to use when they are most needed (Starkweather & Givens-Ackerman, 1997). One stutterer explained that during a stuttering moment, "We are so overwhelmed with all the things that we are 'supposed'to do that we become paralyzed, and can't do anything" (Klein, 2002, para. 8). Voluntary stuttering helps the speaker to stay "in the moment" when real stuttering occurs. Purposeful stuttering also prepares and "warms-up" the speaker for using speech tools such as pull-outs, during real moments of dysfluency, when they are most needed.

Practice Assignments:
2A. Speak to a friend or relative and voluntarily stretch the first sounds of words. Take care to stretch or prolong only the first sounds of words because this is where most stuttering occurs (Andrews et. al., 1983) (Example: Wwwould yyyyou like to go out for ddddinner tonight?").
2B. Speaking in class, at work, or in other challenging situations, gently stretch the first sounds of words. You may wish to challenge yourself by choosing words that begin with feared sounds or by choosing feared words.
2C. Ask strangers or passerbys questions using gentle, voluntary stretches (Example: "Ssssir, do you know wwwwhere Mmmain Street is?").

3. Increasing Listening Skills -Many stutterers report that they spend so much time worrying about speaking and worrying about the possibility of stuttering that they often have difficulty listening to what is said to them. On the Stutt-L electronic mailing list, an adult stutterer explained, "We're so concerned with our own speech that we lack the focus, time or mental energy to listen to someone else's" (Jezer, 2002, para. 3).

Stuttering on purpose enables people who stutter to better focus on what others are saying. Once the stuttering is out in the open, there is nothing to hide. Instead of worrying about the possibility of stuttering, one is able to listen and focus on what others say.

Practice Assignments:
3A. At the beginning of a conversation, stutter on purpose several times in a noticeable manner when talking to a friend or relative. After doing so, consider if there is any change in your ability to attend to what this person is saying to you.
3B. Choose a high stress situation such as talking during a meeting at work or during a class discussion. At the very beginning of the meeting or discussion, make a comment or ask a question using several noticeable voluntary stutters. After doing so, observe how you feel listening to others talk now that you have gotten your stuttering immediately out into the open.

4. Stuttering Without Shame -Many people who stutter -in my experience, most -demonstrate varying levels of shame during moments of stuttering. Most noticeably, people who stutter rarely initiate or maintain eye contact with others during stuttering moments. Looking away from the listener or at one's own feet during a stuttering moment demonstrates that stuttering is shameful and something to be avoided.

Stuttering on purpose allows the speaker to practice stuttering while making eye contact -this demonstrates self-respect, not shame. As one stutterer put it, "Voluntary stuttering has proved to be a valuable weapon to combat how my stuttering is perceived by others because if I'm comfortable with it other people tend to be as well" (Henry, 2005, para. 2). One way to establish this "comfort" level with stuttering is by entering into a situation with the plan of stuttering voluntarily while initiating and maintaining eye contact. It is important to note that the speaker is not expected to maintain unbreaking eye contact during an entire conversation -that is unnatural and may be perceived by the listener as threatening or odd. Instead, the stutterer is asked to initiate and maintain eye contact during voluntary and real moments of stuttering.

Practice Assignments:
4A. During a conversation with a friend or relative, stutter on purpose at least three times and make a point to initiate and maintain eye contact during the stutters. If the voluntary stutters turn into real stutters, continue to maintain eye contact.
4B. While ordering a meal at a restaurant, stutter at least three times to the waiter while initiating and maintaining eye contact during the stutters.
4C. Ask questions at stores or local businesses while initiating and maintaining eye contact during the stutters.

5. Reducing Moments of Stuttering -It has been my experience that over time, the use of voluntary stuttering will reduce the speaker's fear of stuttering which will lead to reduced moments of real stuttering. This is in spite of the fact that voluntary stutters occasionally turn into "real" stutters. As one adult said to me with great exasperation, "Why should I stutter on purpose if it sometimes causes me to get caught in real stuttering?" This same gentleman confided in me that when he used voluntary stuttering his real stuttering tended to either disappear or be reduced. By entering into situations with the goal of stuttering on purpose, his fears of stuttering were greatly diminished. This reduced the frequency of his stuttering.

Practice Assignments:
5A. During an extended conversation with a friend or relative (at least five minutes), stutter on purpose in a clearly noticeable manner throughout the conversation. Observe if this leads to more or less "real" stutters. Repeat this assignment many times.
5B. Call local shops and stores and ask questions while stuttering noticeably on the very first words that you say. As you continue to make calls, observe if you are producing more or less "real" stutters.
5C. Choose a situation that you face on a regular basis such as a weekly meeting at work or a weekly family dinner. Each week, use voluntary stuttering during this situation in a noticeable manner. Observe to see if you are producing more or less "real" stuttering.

Reference List:

Quotes that are cited from electronic mailing lists are used with permission of the authors.

Andrews, G., Craig, A., Feyer, A.M., Hoddinott, S., Howie, P., & Neilson, M. (1983). Stuttering: A review of research findings and theories circa 1982. Journal of Speech and Hearing Disorders, 48, 226-246.

Breitenfeldt, D.H., (2003, October 1). A stutterer's odyssey through life. Paper presented at the 2003 International Stuttering Awareness Day Online Conference. Retrieved March 7, 2005 from http://www.mnsu.edu/comdis/isad6/papers/breitenfeldt6.html

Carlisle, J.A. (1985). Tangled tongue: Living with a stutter. Toronto, Canada: University of Toronto Press.

Heite, L. B. (2001, October 1). La petite mort: Dissociation and the subjective experience of stuttering. Paper presented at the 2001 International Stuttering Awareness Day Online Conference. Retrieved March 7, 2005, from http://www.mnsu.edu/comdis/isad4/papers/heite4.html

Henry, J. (2005, June 7). Stuttering chat: Online support for people who stutter [Msg. 35027]. Message posted to Ref-Links electronic mailing list, archived at http://groups.yahoo.com/group/stutteringchat/message/35027

Jezer, M. (2002, September 24). Stutt-l: Stuttering: research and clinical practice. [Msg. 001871] Message posted to Ref-Links electronic mailing list, archived at http://listserv.temple.edu/archives/stutt-l.html

Klein, J. (2002, January 13). Stutt-l: Stuttering: research and clinical practice. [Msg. 0085] Message posted to Ref-Links electronic mailing list, archived at http://listserv.temple.edu/archives/stutt-l.html

Madsen, J. B. (2005, March 6). Covert-s: Covert stuttering. [Msg. 1464] Message posted to Ref-Links electronic mailing list, archived at http://health.groups.yahoo.com/group/Covert- S/message/1464

Manning, W.H. (2000). Clinical decision making in fluency disorders. San Diego, CA: Singular Publishing.

Starkweather, C.W., & Givens-Ackerman, J. (1997). Stuttering. Austin, TX: Pro-Ed.

Starkweather, C.W. & Givens, J. (2003, October 1). Stuttering as a variant of post traumatic stress disorder: What we can learn. Paper presented at the 2003 International Stuttering Awareness Day Online Conference. Retrieved March 7, 2005, from http://www.mnsu.edu/comdis/isad6/papers/starkweather6.html

Van Riper, C. (1973). The treatment of stuttering (2 ed.). Englewood Cliffs, NJ: Prentice Hall.

Van Riper, C. (1982). The nature of stuttering (2 ed.). Englewood Cliffs, NJ: Prentice Hall.

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July 18, 2005