Why Do So Many Stutterers Fail to Stutter When Alone and How Can This Phenomenon Be Used in Treatment?
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About the presenter: Dr Ilia U. Rasskazov, from Moscow, Russian Federation, is a certified psychiatrist, General Director of Scientific Research Center "Yamir", member of Coordinate Council of Ministry of Internal Affairs, Psychology Department. |
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About the presenter: Dr Natalia M. Rasskazova is a certified psychiatrist,certified psychotherapist, the Lecturer of Moscow Institute of Psychoterapy and Clinical Psychology. |
Why Do So Many Stutterers Fail to Stutter When Alone and How Can This Phenomenon Be Used in Treatment?
by Ilia U. Rasskazov and Natalia M. Rasskazova
from Russian Federation
Some time around one hundred years ago there were three small clouds on the horizon of the Newton model of physics; three facts which could not be explained and later became the basis for the development of quantum physics.
Here is a proposed discussion of facts yet to be explained regarding stuttering, the causes of which are still poorly understood:
- Why do the majority, approximately 65%, of people who stutter speak fluently, and about 25 % of people who stutter stutter significantly less when they speaking aloud or reading aloud while alone in a room and sure that nobody can hear them.
- Why is stuttering not present in "conversations" with pets or small children
- Why is the speech of people who stuttermonotonous
- How do people who stutterconvey their moods and emotions to other people
- Why does stuttering return even after speech therapy
At the International Stuttering Association 2007 Congress in Croatia we spoke on the interesting coincidences in reporting on two independent Internet sites devoted to stuttering, www.zaikanie.ru which is aimed at Russian speaking people who stutterand www.speechhelper.com, aimed at English speaking people who stutter. The possibility of double-voting was excluded, and participants answered the following question: Do you stutter when you speak "alone in a room" (when you are speaking aloud or reading aloud, speaking to animals or to a pet, when no one is around to hear you?
The latest (September, 2007) data are quite similar to data from April 2007 (the difference is less than one percent) and, the percentage obtained from the Russian speaking and English speaking audiences have high correlations - 0.94.
Results obtained from the 1485 Russian speaking respondents showed that 65.66% (975 persons) do not stutter under such circumstances while 27.47 % (407 persons) stutter significantly less under such circumstances. Only 5.25 % (78 persons) claimed to stutter as they would in real conversation. 1. 62% (24 persons) found it difficult to answer the question.
Results from the English speaking audience are as follows: 62.57% (107 persons) do not stutter and 22.22 (38 persons) stutter significantly less under these circumstances, 11.11% (19 persons) continue to stutter just as in real conversation, and 4.09% found it difficult to answer.
It is interesting that the majority of people who stutter state that they do not stutter when alone. In John Pashkevich's film "Unspeakable" a young man troubled by stuttering speaks fluently when alone in the room and recording his own thoughts on tape, but stutters remarkably in front of the shop Salesgirl. When not in the presence of other people, the majority of people who stutter can express themselves fluently. However, when it comes to having a live conversation (active conversation with another person), even with close friends or relatives, many begin to stutter. There are also those who, while it may be reduced, continue to stutter when alone though, this is certainly not the majority - only 5-12%.
This may be an indication that stuttering has a heterogeneous nature. It may be that for some stuttering has organic causes, as symptoms are stable and do not depend on other factors. There is in fact a tendency to explain stuttering as a dysfunction of the medial pre-motor system of the brain, and involvement of the basal ganglia comprising this pre-motor system.
However, 60 - 65% claim that stuttering appears only in communication situations involving other people. In these cases the symptoms of stuttering appear only under certain circumstances -- when another person appears. This finding leads many to believe that there may be significant psychological aspects of communication present in developmental stuttering.
Some people who stutter insist that they do not experience psychological discomfort during communication, even when stuttering, although these same people are not dysfluent when alone. It is our belief that the discomfort may be a deeply subconscious phenomenon requiring professional help to realise. It is analogous to the person suffering from chronic muscle tension but who does not notice the tension; to him it feels normal. It is only when experiences of others are fully understood and comparisons made that these clients agree that they previously felt psychological discomfort during communication.
In these cases dysfluency may be considered a natural human reaction that reflects inner psychological discomfort during communication similar to feelings of weakness or shakiness, having an audible, thumping heartbeat or experiencing dizziness or sweating. These symptoms of discomfort usually appear in stressful situations such as talking to people who give the appearance of being dangerous, a tyrannical boss or, in the case of a small child, to a strict parent. They may also appear where an individual is feeling guilty. The person who stutters is unable to maintain fluency under these circumstances and speech becomes fragmented. Any individual, even normally fluent persons, can experience stuttering symptoms given the right conditions and conversational partners.
Whether stuttering is purely physical, purely psychological, some combination of the two, or arises from different causes for different individuals, addressing non-verbal rapport with other people may be very beneficial. The problem of establishing non-verbal rapport with other people has been and is today thoroughly studied by social psychologists and psychotherapists. Recently, in August 2007, the research of Kellogg School Associate Professor Adam Galinsky and co-authors William W. Maddux of INSEAD and Elizabeth Mullen of Stanford won an award for Best Paper - New Direction (the paper is to be published in the Journal of Experimental Social Psychology). Their research demonstrates the process of mimicry produced in negotiations and proves that the quality of non-verbal communication is very important for those looking to be successful in business and in their attempts to climb the career ladder.
Speech itself can be divided into two parts: a verbal part (the actual words which convey information), and a non-verbal part (conveys mood, emotion and interest towards the conversational partner).
The non-verbal part of speech is known as intonation and consists of rhythm, pauses, range of pitch, and the dynamics of voice frequency. With the help of intonation it is possible to convey mood. Another parameter important for non-verbal communication is the "level of intoning" or "percent of intoning" which reflects our psychological distance from our conversational partner, and shows our interest in a particular conversation or conversational partner.
Conveying emotions and/or attitude toward a subject of discussion is the essence of communication. People convey emotions with the help of intonation, more specifically with rhythm and the dynamics of voice frequency. It is interesting that according to Prof. Jacomo Rizollatti the medial pre-motor system is responsible for the sincere expression of emotions. Those mirror neurons which play a significant role in the establishment of non-verbal rapport and our ability to understand another person's intentions are located in Broca's area.
Stuttering is also evidenced by a group of more nuanced elements: low levels of intoning, poor mimicking, lack of expressiveness, and low levels of non-verbal communication. Those who do not stutter typically speak with a great deal of emotion, whereas the speech of people who stutter is typically more monotonous, conveying only information, rather than emotions or attitude.
It is interesting that when a person who stutters starts to use intonation and pay attention to rhythm, he stops stuttering or his stuttering is greatly reduced. Many people who stutter find it difficult to express their sincere emotions verbally. A major difficulty is the establishment of non-verbal rapport (including non-verbal rapport in speech). If the majority of people who stutter can speak fluently when alone, it could be thypothesized that they do not have problems with the part of their brain responsible for speech.
This paper suggests that behavioral mimicry (also called "mirroring" in NLP) is a natural automatic behavior in communication with another person. Behavioral mimicry is the unconscious mimicking posture, facial expressions or gestures, and the other person's speech pattern. It is important for us to be able to gauge our level of synchrony with other people, and to match our behavioral and verbal patterns with theirs. This synchrony reflects trust, psychological comfort, or what is otherwise known as non-verbal rapport.
One way of treating stuttering may include working to develop these non-verbal communication skills -- a serious effort by people who stutter to gain control over speech rhythm and intonation patterns.
We believe the topic of virtual communication modeling is of great importance for people who stutter. Since 2001 we have been involved in the development of objective instruments designed to determine a person's speech rhythm (tempo-rhythm) and level of intonation. When comparing the percentage values of a live person with the values of virtually modeled communication situations, we can objectively assess a person's ability to establish non-verbal rapport with his/her conversational partner.
We look forward to meeting with, talking with and, cooperating with anyone interested in the further development of this idea!
August 30, 2006
