Stammering For Dummies

A self Help manual

from

The Indian Stammering Association

(Second Draft 10th March 2009)

Table of ContentsIntroduction .................................................................................................................. 3

This Manual .................................................................................................................. 4

Know thy stammer ........................................................................................................ 5

Step 1 (Play with a tape or a video camera)

Step 2 (replay and review)

Step 3 (get in touch with emotions)

Step 4 (wider explorations)

Working on your speech ................................................................................................ 8

Stuttering modification

Self exposure

Bouncing

Voluntary stuttering

Secondary Behaviors

Fluency shaping

Gentle onsets & Prolongation

Correct breathing

Pausing

Working on your emotions & Attitudes .......................................................................... 18

Karma theory

God’s glory

The House is Empty

Little Versus Big cross

Transfer to outside world ............................................................................................. 21

Maintaining the gains- SHGs ........................................................................................ 22

Zen of stammering ...................................................................................................... 24

Beyond Stuttering: Deeper Issues of Life ...................................................................... 26

TISA: Philosophy & Approach ...................................................................................... 28

Introduction

Stuttering affects both the speaker and the listener. But both parties do not acknowledge it

under some kind of unsaid convention or arrangement. Yet, there is a significant

frustration on both sides. On the speaker's part, because he feels that he has failed one of

the most basic requirements of social transaction. On the listener's side- because they

have no precedent or understanding to make sense of what just transpired; nor did they

feel free to ask questions. Stammering has often been compared to a hippo sitting

between two conversationalists at a coffee table: unwelcome and unacknowledged- but

very much there (see the cartoon below).

About 1 to 3 people in any adult population of hundred may stammer. The incidence is

higher than that of HIV+ people in India, three out of a thousand males1. Yet we know

more about AIDS than about stuttering. Most of us stammerers and non-stammerers, alike

have erroneously believed that the problem will go away if we do not acknowledge it, if

we do not talk about it. It usually does - by going underground- but always returns with a

greater force.

Few Speech Language Pathologists (SLPs or Speech Therapists) specialize in stammering-

so called fluency disorders. Even these few are forced to migrate elsewhere for lack of

enough work and recognition in India. Why dont PWS come forward for therapy? Even

when it is offered for free? They have explored every bit of their mind and mouth, speech

and various strategies but have failed to answer the basic question: why do I stammer

sometimes? Not all the time? How can I help myself?

Since we are dysfluent some times and fluent the rest of the time, we intuitively realize

that the problem and solution both lie in our own mouth. And yet nothing seems to work

1 0.3%: Estimated percentage of adults (ages 15-49) living with HIV/AIDS by the end of 2007 (UNAIDS

2008 Report on the Global AIDS Epidemic. July 2008.)

consistently. The result is: we give up hope and become skeptical. Haven't we tried

everything? What can a Speech Therapist tell us that is new? Either we withdraw in to a

receding shell of denial or go about life with fatalistic acceptance of our speech and

associated issues.

Today most PWS seeking professional help are young. They are at a stage in life when

developing associations, building relationships and excelling at academics and career is of

great importance. All this requires communication skills. Hence most such young clients

are desperate for a fast “cure” as they understand it. Even when SLPs are able to convince

them for the need to work on a long term therapy goal of managing their stutter rather

than eradicating it, few persist with the therapy and relapse into old ways of

communicating. The reason is: few PWS are able to keep their motivational level high

once they are out of the therapy program and secondly, there are no self help groups,

where they can practice their new skills and get ongoing support.

The Indian Stammering Association (TISA) tries to fulfill these needs through this self help

book. Use it as a manual and start a self help group in your neighborhood, workplace or

on the web. Stuttering is one health condition, where your well-being is truly connected

with that of the others. It has been termed a disorder of social presentation of oneself (-

we don't stammer when we are alone and talk to ourselves-); Hence the “cure” too has to

be found in social settings. One last word, this book will absolutely do nothing for you if

you do not practice the concepts described here in! Instead of reading it as an informative

book, work with it like a 'Do it yourself manual' over a period of 1-2 years or even longer.

This Manual

This manual is primarily meant for PWS, especially covert stutterers and those who suffer

from so called “mild” stuttering; Those with a greater degree of stuttering or related

problems, should consider other approaches: consulting a SLP, joining a self help group,

talking to an older PWS etc. Finally those PWS who can not do any of these, even they

may learn some helpful ideas from this manual.

Equipments : These equipments will be needed for some of the exercises. A simple tape-

recorder; a video camera (even the cell-phones with a video camera will do), a diary to

keep notes (you could even blog if you are a ‘leo’ and courageous!), a mirror. Finally,

having a sympathetic friend or a support group can help tremendously- by offering us

objective feedback and other support, as we go along on this path of self-discovery and

self-mastery.

Know thy stammer

Know thy stammer and thy stammer shall set you free

This might seem like stretching an old adage a little bit too far- but nothing could be truer

than this. We live in a bubble of denial where we do not know our stutter and the related

behaviors, feelings and attitudes at all. All we do know is the uncomfortable response we

get occasionally from our audience. Uncomfortable response? to what? To our speech, that

is about all we know. But what did we do with our speech mechanism, our breathing

muscles, facial muscles, our eyes, our limbs, posture – in that passing (-our judgment of

time also is impaired-) moment of great difficulty- this we do not know. Some PWS

compare that moment to the confusion and desperation of someone suddenly drowning.

How did we psychologically react to that moment of difficulty? Did we give up the forward

movement of speech in our confusion and distress? Did we exaggerate the movements of

our hand or head to get the word out? Did we feel irritated by the listener and hold them

'responsible' for our difficulties? What exactly transpired through our body and mind in

those moments- this we do not know. All that we are aware of is a vague ache and

tension in the throat, chest, face and a sense of failure, embarrassment and helplessness.

We have learned from our childhood to despise and shun our stammering. But since it

does happen in spite of this, our conscious mind plays a trick and 'erases' these

uncomfortable moments from the 'tape' of our day to day memory- some kind of on-line

editing of a live show. The conscious mind denies the problem and takes no cognizance of

the events. It is relegated to the realm of 'unconscious' behavior or reactions. Many PWS

believe that it is not they who do their stuttering: it just happens by itself! And hence, how

can they do anything about it? So, there is no cure for it!

In this first step, we will learn how to regain control of the 'lost kingdom' and discover that

it is we who stutter and not our mouth doing it on its own. To do this, we record, review,

study and analyze our speech in following steps. A word of caution, this is the most

difficult and painful step, but if you can do it, three quarters of the battle is won:

Step 1 (Play with a tape or a video camera)

Record your speech under different circumstances: reading a newspaper or a book; talking

to yourself or children, talking with a friend or in a small group. Start with the most

comfortable situation, like reading alone. Use a simple audio tape or a cell-phone with

camera, whichever is convenient. The latter will have the advantage of recording both

your speech as well as your facial expressions.

For the first few minutes, you might be too conscious of the recording but later you will

get used to it and speak in your normal style. So let the recording be long enough, 5-6

minutes or more. In your diary, record the date, time and situation (reading alone, using

phone, discussing in group etc) under which you recorded. If you are using the phone

camera, you may use a friend. If this friend is a PWS, all the better. Essentially it can be

anyone you trust.

Step 2 (replay and review)

Replay the tape- listen to your speech, study your body language, facial expressions,

hands etc. if it is a video recording; review these even in those moments when you are

speaking fluently. Compare this, with those moments when you are having a little

hesitation or difficulty. As a listener now, try to guess how you are coming through as a

speaker. Confident? Comfortable with yourself and the subject? Enjoying every moment of

it? Or in a hurry to finish? Based on what you see and hear, try to guess, and feel, your

emotional and psychological states as you were speaking those words on the tape. Replay

the moments when you think you were not very comfortable. Pause the tape frequently to

see and hear: did your pitch go up as you came across a 'difficult' word? Was there a

struggle to push out a difficult sound? Did your lip press together with greater force and

for longer duration than you would normally expect? Record your observations in the

diary, against the entries you made in step one above.

Step 3 (get in touch with emotions)

Review these recordings over a long period- 3-6 months and try to note down, what you

do differently, in the moments of difficulty as opposed to when you are speaking fluently.

It will be even more useful, if you could review these tapes with a trusted friend or a

recovering stutterer. You could go a step further and fake your stutter while alone- and

stay in that moment for a couple of minutes- to know what it actually feels like, in mouth,

in body and in mind. In other words- consciously reproduce a moment of your stuttering

and hold it (freeze) there: My name is s-------------achin. I live in K-k-k-k.....Kanpur. Etc.

If you could do it in a normal conversation with a pet, children and friends (in this order),

you would even discover unique emotions associated with your stuttering, but completely

unknown to you till then; buried deep in your core. So, later on, when you start to deal

with your stutter, you address not only what your mouth does, but also what your mind,

your emotions do in those moments of difficulties.

Step 4 (wider explorations)

Meet other PWS, read their posts on chat groups, their biographies on web. While reading,

try to compare your life with theirs; your observations with theirs; your problem-solving

approaches with theirs. This will help you to understand that:

1. Your experiences as PWS are not unique and

2. your responses to your problems are also not unique.

You can learn form their experiments. Knowing your 'speech' is not enough; you must

know yourself as a total human being: your attitude towards life, relationships,

responsibilities, career, recreation, creativity - and how these have been influenced by your

speech; your deepest fears and aspirations. One way is to meet others on the same path

and compare notes and the second complimentary path is diving within yourself: sitting

quiet and reviewing your life, contemplation, meditation. Vipassana meditation has helped

some people in this regard. Read more about it later in this manual.

Step 1-3 should be repeated as often as you want, with your review and analysis

becoming deeper and deeper. It needs courage, determination and some 'quality' time to

go deeper. Finally, a time should come when you know your stammer so well that you can

reproduce it 100% at will in a mimicry contest among friends! This signifies complete

emotional healing- an important stage in the long journey. But there is more to be done,

so that your audience is able to understand what you are saying. You still have to become

a good communicator( if not 'orator').

Working on your speech

Many years ago, a rabid dog charged at us. I slipped in to the car, closed the door and

peeped out of the window! Another colleague of mine went out, took a stout stick and as

the dog approached the car, he dropped it dead with one well placed blow to its head.

Both approaches are fine. Yet, there is another approach: we could stay out, paralyzed

with fear and be bitten! This last approach, many PWS have tried and found unsatisfactory

in the long run.

The first approach is like Fluency shaping techniques; You build up on your inherent

fluency; actually, you stop interfering with your natural ability to produce normal fluent

speech. Your desire to be fluent does the rest.

The second approach, stuttering modification, is a better one in my opinion because it

teaches you to conquer your fear- not only of stammering- but of everything else on

earth. Instead of running away from a pack of monkeys, you steadily walk towards them,

and they scatter.

Finally, it will be good for most of us to learn and practice both kind of approaches since

these techniques are not exclusive or antagonistic.

Stuttering modification

Self exposure

For many of us, denial becomes so ingrained that not even in dreams, will we accept our

speech difficulties. So here we begin from simple to difficult tasks, in the following

suggested order:

1. While in the shower (or anywhere private) whisper or say to yourself for some days

- I stammer. Yes, I stammer. And this is fine...

2. When you are comfortable with the above, say that or something similar to your

pet (dog, cat, bird, lizard or Mamba!) or a child - You know, sometimes, I feel

totally stuck; cant say my own name..

3. Now say the same thing, after some days, to your nearest relative or friend (wife,

mother, friend- but not to boss yet!)- You know, sometime, I get totally stuck; cant

say the simplest things..

If they ask a question, answer that briefly, objectively without excitement.

4. After you are comfortable with the above steps, try doing the same with a

colleague, a chance acquaintance, someone sitting next to you in a bus. Make sure

that you sound casual and that the occasion is appropriate, that the other person is

not in a big rush. Having said it, make a note of their reaction. Was it different from

what you expected?

5. Next, after some months of constant practice, when you have to give an informal

presentation or group talk, start casually with something like this:

You give me just two minutes. Unfair, because with my tongue (or my stammer) I

am sure I am going to take four minutes. How many of you are willing to give me

four minutes? Please raise your hands...

And then begin full steam ahead, with a smile..

Experiment with this and other ice breakers and ‘humorous’ opening lines for PWS

listed on Judy Kuster’s home page2. An important thing to remember, while talking

about your stutter is to keep an eye on your emotions and remain calm. This will

become easier as you do it frequently under different circumstances. Also, take

note of your listener’s response. Almost always, they accept it as a matter of fact.

This self exposure can take other forms too- a blog, messages to chat groups,

letters to editors of local dailies, a poem or a story etc.

6. Rewards (the outcome): When you have done this enough, there will be

complete acceptance in your heart and mind for your ‘stuttering self’. Then, when

you open your mouth to speak, there will be no ‘role conflict’ between your

‘stuttering self’ and ‘fluent self’- and your speech will be quite smooth.

Bouncing

We have noticed that sometime, under stress, our mouth just runs away with words and

we feel helpless, as if we have absolutely no control over our speech box. Bouncing is a

technique which gives us back the control over our speech mechanism and related

emotions. It also teaches us to stutter in a relaxed way- as very young children do. This is

2 http://www.mnsu.edu/comdis/kuster/publicrelations/pr.html#presentations

the purpose of the self-therapy here: to teach us to stammer as a four year old child does.

That effortless stammering is less tiring to us and less distracting to the listener as well.

Lastly, it is a nice way of self exposure- Telling people that we stammer and getting used

to their reactions.

Here are the main rules:

1. Start with easy, simple words. Bounce on difficult words only after 2-3 months of

regular practice with easy words. By difficult words we mean sounds which pose

problems regularly- for example for some of us, it could be K (as in Kanpur); for

others it could be B (Bimal), P (Peepul) etc.

2. Practice alone for a few days; When comfortable, do it with a friend or in the self

help group or on phone with friends or strangers.

3. Read a story book or news paper and bounce on every second or third word in

every sentence. Finance m-m-m-minister has d-d-d-decided to l-l-l-lower the

interest r-r-rates...

You just repeat the first sound (syllable) slowly. SLOWLY is the key principle here.

4. Avoid bouncing rapidly, which happens sometimes during uncontrolled stammering:

Finance mmmminister has ddddecided to llllower the interest rrrates..

This is bad bouncing. This can be avoided by stopping completely and being totally

relaxed between two bounces.

5. Vary the number of bounces. Start from 6 or more bounces and then gradually

reduce it to 2-3. Then, again increase it to 5-6 or even more. The idea is to get

totally comfortable with this technique and develop good control.

6. Finally after some months’ practice, you should be able to say a word with just one

small relaxed unnoticeable bounce: Finance m-minister has d-decided to lower the

interest r-rates...

If you watch TV carefully, you will notice many speakers, anchors using this little

(sometime even bigger ) bounce frequently.

7. While learning to bounce, pay close attention to your emotions. Bounce as a child

does. No fear, no struggle and with total acceptance.

8. Now, is the time to start tackling difficult words in the same way and in the same

order. Start with a close friend and then with colleagues and finally with strangers;

first at home, then in the work-place and still later try it in a bus or train etc.:

Give me a ticket for Ha- Ha- Herbertpur.

Gradually, try to bounce on a difficult word in a spontaneous conversation on phone

or in person.

9. Whenever you fail to bounce properly on a word go back couple of steps and start

again. Bounce on that very word, alone, then with a friend and then with strangers.

Voluntary stuttering

Voluntary stuttering involves- not bouncing- but actually reproducing your natural normal

stutter at will. At will is the key word here. When you stutter, you have no control over it;

And that is what is disturbing and painful. Now you have to study your stammer - which

you have already done, and reproduce it in all its detail and perfection. Dont exaggerate it,

dont make it humorous or funny. Just mimic it.

Again start from - doing it alone, then with a trusted friend, then in your self help group

and then finally with someone in the street.

But why are we doing it? To get rid of the deep seated fear and shame and also to

become conscious of all the things which we do, and which interfere with communication,

our natural fluency.

If you can mimic your stutter perfectly, you can conquer it!

A good exercise is to read a book or a news paper and stutter voluntarily on a word in

each sentence and then immediately repeat that word with a relaxed bounce. This will

teach our nervous system the big difference between ‘hard blocking’ and a gentle bounce.

While trying voluntary stuttering, try to relive everything associated with your stutter: the

emotions of fear and shame, tightness in throat and chest, closing of throat, lowering of

gaze, jerking of hands or head etc. Remember, all this has to be done at will and stopped

at will.

This mile stone signifies your conquering of fear of stammer. Many PWS live in chronic

fear:

what will I do if I get totally stuck on a word or my own name in a formal meeting- and

just cant get out of that block?

If you have come thus far, you exactly know what you will be doing in such a situation and

so you can go back to sleep or whatever creative projects you are doing in your life!

Secondary Behaviors

Stuttering is not just fractured speech. There are secondary behaviors, which we have

picked up over our growing years, in search of some relief. All these secondary behaviors

have helped initially but now have turned into useless junk mannerisms. In fact, they

interfere with efficient communication. And still we indulge in them. Why?

This is because most of us are not aware of these secondaries: raising of an eyebrow,

blinking of eyes, flaring of nostrils, tilting of head back; pitch rising as we approach feared

words, tightening of chest and holding the breath, fiddling with hands etc. Once we are

aware of them, we slowly develop a conscious control over them, and with some

persistence, can get rid of them.

Here are the steps:

1. First we must become aware of these. As in earlier steps, study them with the help

of a video camera, mirror and or a trusted friend.

2. Develop a complete list of all such unconscious reactions to difficulties faced during

verbal communication.

3. Study these behaviors under different circumstances, talking to different people,

discussing various things (telling a joke, reading a formal report, role playing,

during a verbal confrontation, when very angry or excited etc).

4. Now get down to changing these secondaries: Let us take the example of eye

blinking. In front of a mirror or a video camera, change (and review) the rate and

type of blinking through a wide range of settings. For example, blink very fast while

talking; then slowly. Then, shut your eyes completely and say a complete sentence.

Then, time your slow blinking with every pause in a sentence (comma, semi-colon

etc). Then, stare without blinking and say a complete sentence or two. Then, do

the full exercise with another person. Frequently replay the tape and review the

behavior.

5. Gradually, this will help you to develop better awareness and conscious control over

eye blinking and you will find that now, when you talk, you are able to control or

even stop this particular secondary behavior. Similar exploration and

experimentation should be done with every secondary behavior. Initially take them

up alone and then try various combinations- eye blinking with hand movement;

trembling of lips with head jerk etc.

Points to ponder

Almost all the above steps require a lot of courage, a sense of adventure, a spirit of

inquiry and a determination to face the truth, however painful it may be. Almost always

the first step is the most difficult one. Once you begin, it becomes easier. The old fears do

return once in a while, but shooing them away becomes easier and easier.

Now the problem is- no one can thrust this journey on us. A point comes in our life, when

we feel that we have suffered enough, in silence and alone; We become aware that this

kind of suffering is meaningless; It neither turns us into a martyr nor does it lighten

anybody else’s burden. We discover that our old way of dealing with our stammer is totally

non-productive, non-creative. It offers only one plus point: it is familiar and therefore feels

more secure.

When we reach this turning point in our life, we are ready for a quantum leap. This

manual tells you how to land on both feet safely - but leap, YOU must.

Fluency shaping

Fluency shaping is the other approach to stammering: We all have noticed that sometimes

we are quite fluent- like when talking to a child or a pet or on a topic well known to us.

But when we are under stress (sometime even without stress) that fluency vanishes. Why?

Because under anticipated stress, we do certain things which interfere with that fluency,

like tensing our lips, holding our breath, tightening our throat muscles etc. Some of the

main approaches under this are as follows.

Gentle onsets & Prolongation

Gentle onset means that we pay close attention to our beginning of a word / sentence.

PWS often tense up, tighten their lips and jaw and start in a jerky uncontrolled fashion.

With some practice and conscious attention, it is possible to start a sound gently. And

then, prolong the sound. To beginner it may seem like speaking with a foreign accent. It

involves prolonging the vowels, especially the initial sounds. It helps us to slow our speech

down and be comfortable with the act of speaking itself.

To begin the practice, read a newspaper or book with prolongation of vowels in every

second word or more: Aai weel go too Kaaanpooor toooomorrow (I will go to Kanpur

tomorrow). Then, practice it with a friend in general discussion. To understand what does

prolongation mean, you may have to talk to some PWS already practicing it or watch a

video of the technique. The latter is available on web.

You begin with non-feared words and situations to feared words and situations gradually.

For example you may talk like this to your pet dog and then gradually to your friends and

family members for increasing durations. You may slide back once in a while, which is

common. But regular and motivated practice is very much needed to turn this technique

into a useful skill, you can rely on.

Gentle onsets may even mean, to soften the hard consonants at times: Khum on- leeet us

plaaay (Come on- let us play). Similarly, sounds consisting of double consonants may have

to separate in the process of prolongation: Perroompt (Prompt); Currocin (Crocin).

Initially speaking like this might seem very strange to us but if we observe, many

nationalities speak English (and other languages) in significantly different ways and are

understood well enough: Pay attention to a Russian speaking in English, for example.

Correct breathing

There is medical evidence that different types of breathing achieve different physiological

goals- for example belly breathing ventilates the lower lobes of the lung and this promotes

more efficient exchange of oxygen. There is also proof that when we anticipate stress, we

tighten our chest and belly and our respiration becomes shallow, irregular or even ceases

completely for short periods. Since we are no more breathing out, we are unable to speak.

Some children, on the other hand have discovered that breathing out might help them

during a block. But when they breath out, sometime, lungs get totally emptied and still the

phonation (voicing) does not begin. Finally, they may be able to whisper a few words with

great difficulty with the little residual air.

It has also been noticed that there is a reverse cycle too: relaxed deep breathing can calm

down a PWS and help her/ him gain better conscious control of his speech. Watching one’s

own breath can also induce deeper states of inner consciousness, wherein one might see

his or her avoidances, fears, habitual responses to anticipated stress and other emotional/

psychological issues associated with stammering. Over the months or years, it may be

possible to heal oneself through this path. The technique itself should be learned from a

qualified teacher or in a formal Vipassana course. The technique does not require one to

believe in any supernatural deity. It only demands that one has faith in one’s own senses,

mind and observation.

In practice, it means becoming aware of your breathing at different times of the day; In a

traffic jam, were you using the chest (upper? lower?) or the belly muscles to breathe? As

you thought of an important deadline, did you tighten your chest and stopped breathing

for a few seconds? As you approached a feared word, what happened to your breath? etc.

To develop this awareness, lie flat on the ground and practice three kinds of breathing;

Put one hand on chest and the other on navel (belly). If you practice belly breathing

correctly, the hand on the chest will be still or will move very little. After a few days, put a

thick book across your stomach and try pushing it up, with every inspiration. Later, you

may discover the fine difference between breathing from upper chest and lower chest.

Now onwards, whenever you notice that your breath is irregular, shallow or stopped,

promptly and consciously go into gentle belly breathing.

Pausing

Many of us labor under this false notion that communication means talking non-stop. We

think that a silence in a conversation must be an un-comfortable moment for both parties.

PWS often feel under pressure to prove themselves by talking continuously. But silence is

an essential and natural part of good communication. It should be practiced consciously as

meaningful breaks in the flow where:

1. a clause ends, signified by a comma, colon etc.

2. a sentence ends, indicated by a full stop.

3. a new concept or thought is being introduced

4. you wish to give a few moments for the information to sink in.

5. you expect a response (verbal or non-verbal) from your audience. Listening

attentively to your partner is equally important. Many PWS are too caught up

formulating their response that they hardly listen to their partner, leading to

confusion and communication failure.

Pausing should be unhurried, relaxed and can be used for taking a deep breath,

formulating our thoughts and reviewing audience response, especially during a formal

presentation. Such conscious meaningful pauses help by stopping our speech mechanism

completely; otherwise it tends to gather momentum and become uncontrollable after a

couple of sentences, leading to moments of stuttering eventually.

To practice pausing, begin with reading a newspaper or book, with full attention to

punctuation. Stop completely and take a deep breath at every punctuation (comma, colon,

semi-colon, full stop, hyphen etc.) - and then proceed further. After some weeks, practice

conversation with a friend in a similar fashion: stop and breathe in gently wherever you

think a punctuation mark should be, if you were writing it down. Still later, practice it with

a larger group and under different circumstances.

While speaking in a formal setting, resist the time pressure. If you have been given only

three minutes to present a long report- set up your priorities, leave out all the un (or not

so) important details and present only the most salient information in a relaxed way,

interspersed with meaningful pauses. You may preface your presentation with something

like this: Since I have just three minutes, I will share the most relevant information with

you.

The most important thing to remember is: during a pause your speech mechanism should

really come to a stop and you should be completely relaxed. Here is a group exercise to

develop power to resist time pressure, while speaking:

Sit down with some pea-nuts in the center, with members of your self help group. You

have to ask a question from the person sitting next to you (what is the color of your shirt?

What is the day today? Etc). That member must answer after eating one pea-nut

completely and then carry on asking the question from the next person and so on.

Whoever forgets to eat the pea-nut before answering is out. Whoever lasts till the end

could be titled 'King or queen of Pausing'. This can be a fun game both for adults and

children. (From 'Fifty Activities for the Children who stutter', by Dr Peter Reitzes.)

Working on your emotions & Attitudes

Many people dealing with long term

disabilities or ill-health often wonder why it

was their lot to suffer. Not knowing what

caused the suffering in the first place, the

original cause, becomes an additional

burden. Many of us try to fill this void by

vaguely believing half baked explanations

offered by our culture and faith. This inner

confusion and suffering constitutes a

significant part of the load one carries.

Sheehan’s iceberg is a good way of

explaining that part of stammering which can

neither be seen nor heard. This is quite a

substantial part of the problem called stammering. Nine tenths of an iceberg is hidden

under water and this is the part which can do considerable damage to a ship passing by

(this is what happened to the Titanic in the Nineteenth century!). This again, is the reason

why traditional speech therapy fails frequently: it deals only with the stuttered speech and

fails to deal with the deeper issues.

Case study

A child who was learning to cope with his stammering and its social repercussions, was

one day told about the ‘Karma theory’ by another child. He was already struggling with the

'cross' that stammering represented for him. Now, suddenly he realized that he himself -

and not his 'over-bearing' father, must have been responsible for his stammer: he must

have done some evil karma in his previous births. May be he was a tyrant king who never

allowed his subjects to talk! May be he was a cruel teacher who punished students

severely for talking in the class room! It must have been something truly ugly and sinful to

deserve his lot in the present birth! Suddenly the child was carrying two crosses now: one

for stammering in this life and the other for doing something evil in the last one. Was this

necessary? was this correct?

Many children and people who stammer, struggle to understand, why it has been their lot

to stammer since in most cases they have siblings with normal speech. Quite often they

turn to traditions they have been brought up in. Here under we offer three explanations

and alternative views from different traditions.

Karma theory

Karma theory has often been misunderstood grossly, as in the above case study. Many

people take just the half and ignore the rest. If bad karma generates bad samskar

(tendencies) in this birth, good actions in this birth can and must generate good samskars

and results in this and next birth. If twisting the strands one way can produce a strong

rope, which ties us up, twisting it the other way can undo it and turn a strong rope into

weak strands. This is the 'whole' of the Karma theory. It offers hope. A PWS can get down

to hard work of changing the way he speaks, perceives the world and himself; he can

start a self help group to help himself and others etc. All the good fruits can be reaped in

this very birth if we are committed enough.

God’s glory

Jesus was once passing through a village. A man, who was blind since birth was brought

to him. Someone asked: Is this man blind because of his sins or his parent’s sins? He

replied: Neither. He is blind to fulfill God’s glory.

According to this ‘non-dual’ position, everything is God’s manifestation. We need not hold

ourselves guilty for our imperfections, if we take up this position. In fact, we figure

nowhere in this scheme of things since ‘God has become all the three- the sacrifice, the

sacrificial block and the sacrificer’ according to an Indian saint. Who could complain? Who

is there to complain?

So, what it means is - everything is an appearance. We are given roles to play. These roles

are changing all the time. They do not reflect our truth, our reality. In other words, our

disabilities and our abilities, both are just an appearance, just a temporary role. This may

sound heartless and cruel but many have sincerely believed this and found solace and

peace.

The House is Empty

There is undeniable suffering in this world- as there is joy and happiness. But all these

belong to Nature, not to you or me. There are no entities like your 'self' and my 'self'. Pain

and pleasure exist but do so in a generic sense. Great joy, great pain- all this is there but

the problem starts when we start thinking in terms of 'my joy', 'my pain'. They do not

belong to anyone. The same could be said about ability or disability. This is the third and

Buddhist position.

As a child I had read a children's adventure story, about a haunted house. People's voices

and all kind of noises were heard at night. A group of children had stumbled upon it and

they were intrigued. They thought it was haunted. But when they began exploring, they

found a series of hidden speakers and a tape recorder only. The house was empty! No one

was there, ghosts or living - the sounds were just a trick. Similarly, this body and this idea

of self is empty of any real ‘self’. This is what we find when we go looking for this ‘self’ in

real earnest: The house is empty. The house and the idea of ‘self’ has been put together

by Nature. Then, whose disabilities and suffering are we talking about?

Buddha said, there is a state beyond suffering and there is a path leading to it. But the

first step is to realize that suffering and happiness are both impersonal. This brings a

sense of freedom: we are neither pained by our so called 'failings', nor do we pride

ourselves on our 'achievements'.

There is another, fourth, way of looking at our disabilities.

Little Versus Big cross

Case study: There was a flash flood one night in a village in north Bihar. The family tied up

all their belongings in sheets. The father called the eldest son and put the biggest bundle

on his head and gave smaller ones to younger children. The little one who could not walk

well, he put him on his shoulder. This is how the whole family waded through the water to

a high ground.

Everyone in life has to carry a cross. This is what we discover when we step out of our

'personal' suffering and observe the world around us. Obviously it stands to reason that if

we credit this creation with an intelligent creator, we must accept that It gives us a cross

matching our innate strength. Our trials can never exceed our inner resources. Until we

become aware of that inner strength, life can be difficult, no doubt. But all life is a

preparation for that final flowering.

Finally, when we accept ourselves wholeheartedly, as we are, the world too accepts us and

feels comfortable in our company. That becomes a new basis for communication.

Transfer to outside world

Transfer simply means practicing our new skills in real life situations, moving from simple

challenges to increasingly complex and difficult ones. This is an important step in self

therapy. There is always the temptation to limit your practice of, for example, bouncing or

prolongation to Self Help Group alone. This is simply no good! It is like a ship leaving the

harbor, only to drop anchor two kilometer away in safe waters! But then, this step requires

more of the same qualities, which we needed to launch ourselves on this journey: courage

and a deep sense of adventure. Here are some practical tips:

1. Take along a friend or senior person who stammers, on the initial transfer

assignments. Say, you wish to practice some voluntary bouncing in the local grocery

store, having done it many times in the self help group or just with a friend. Plan

the steps, rehearse mentally and then take a friend with you, to grocery store.

Later, ask the friend to give you feed back about your body language, emotional

states, speech and the reaction of the other person.

2. Keeping a diary can be a tremendous help and boost to motivation. Quite often, we

are so caught up with day to day life, that we may not realize the big leaps we have

taken, the sea change which has come over our thoughts and perceptions and the

improvement in our self-awareness etc. But when we read a diary, we become

aware of these changes and become hopeful for even bigger ones.

3. Writing a blog is the same as writing a diary (or journal). You may make it private

or public or open to just your ‘speech friends’. Advantages are that you can access

it from anywhere and from any computer while working.

4. Phone- You can start using the phone more often now. Many PWS and CWS have a

deep seated fear of using a phone, especially when others are around. You may

phone friends, colleagues and others on various pretexts. You may also call various

help lines or service numbers, since they deal with inquiries all the time and will

most likely be patient with us. For example, if LG is offering Televisions at special

price during some festival, pick up the phone and ask them various questions about

their offer. Finally, what should you say, if anybody asks you about such phone

calls? Be honest and say- I am practicing my speech therapy goals!

5. Get back to your community with volunteer help in various public roles, on various

committees- Durga Puja committee, Neighborhood Cleanliness committee, Swajal

user's group etc. Consider doing so in your work organization too. Earlier you shied

away form such roles. Now is the time to get back in to these roles and give back

to the society at large.

Maintaining the gains- SHGs

In 19th century southern France, many deaf people were working in vine yards. It gave rise

to a sub-culture, wherein deafness was not considered a disability and deaf workers had

no problem in social interactions and finding work. Many people with visible or audible

departure from the 'expected' norms in a society, search for acceptance more, than mere

'cure'. Many gay and lesbian couples prefer living in communes for the same reasons

today. People who stammer are just about 1-2 per hundred among the general population.

They are scattered. They can not start a commune for a variety of practical reasons. If

they did so, society would lose yet one more opportunity of coming to grips with the

diversity hidden in its bosom.

A good compromise seems to be the self help groups. A self help group can be good

strategy to maintain the gains of self therapy. SHG is based on the following principles:

1. True acceptance to a CWS or PWS can be offered by people who stammer

themselves, who accept it and are not ashamed of it.

2. Such people, having tried out various therapies and management approaches, can

share their experiences, coach and guide others. They carry more credibility as

counselors.

3. Their motivation is more likely to be self less and not based on commercial

considerations.

4. They can provide a suitable atmosphere for the younger PWS/ CWS to practice new

speech motor / cognitive / affective skills.

5. Such groups, consisting of PWS, is likely to be free from other divisive influences:

church affiliations, allegiance to commercial interest groups or therapy approaches

(McGuire Versus Speech Easy, for example).

Some practical modalities to start a self help group are as follows.

1. It can be started even with just two PWS. When the number goes above 10, ideally

a second support group should be started. This is so because, if a group meets for

an hour or so, then, not more then ten members will be able to get 3-5 minutes of

talking time. It is important that every member in a SHG gets a chance to talk and

share his thoughts.

2. The self help group should be convened or facilitated by a recovering PWS. While

there is no known 'cure' for stammering, when a PWS starts to accept that he or

she has a communication problem and starts to do actively something about it, she

or he should be termed 'recovering PWS'. Now, if she or he can spare sometime, to

organize such a group and facilitate it, they will be the ideal SHG coordinators.

3. Role of SHG coordinators: A SHG coordinator needs good 'people' skills (counseling,

motivating, facilitation, problem solving etc) and information management skills.

They will be gathering objective self help information and sharing it in the group 2-

4 times a month. They will be conducting various interactive speech (motor,

Cognitive, affective) exercises in the group, ensuring that everyone gets equal

opportunity to participate- paying close attention to the special needs of girls/

women and young children. TISA can help provide necessary training and skills to

such volunteers. Essentially, they have to play the role of an elder, a coach and a

sympathetic (but well informed) friend.

4. What activities should a group do, month after month? There is no end to the

creativity and imagination of the group. There are many good documents on the

web, which give specific details of activities to be conducted in a SHG. Check

following links.

Inter-group visits, contacts, inviting subject experts or other relevant people

(principal or teachers from a local school) could be good ideas when a group has

started functioning regularly.

5. Individual participation in such a group may not be regular. This is because

stammering is a variable condition. When we are passing through a bad patch or

when we are facing a specific challenge like upcoming job interview, our motivation

to take part in SHG may be high. Later on, it may fall, when we are having no

problem with speech for days. But as long as a core group is available to welcome

and induct a new member, it is not a problem.

6. A Self help group can also be based on Internet or telephones- with occasional face

to face meetings. This is especially true of big cities, where members may find

commuting very time consuming. Such a group can be set up by the coordinator

easily at Yahoo and other social networking sites. Check this one group, which has

been functioning since 2001 and has 400+ members:

http://health.groups.yahoo.com/group/IndianPWS

Skype and other VOIP technologies can also help such tele-groups and may become

popular in near future, when poor bandwidth and connectivity problems have been

removed.

Zen of stammering

“Adversity is Opportunity turned inside out”

Here is what a stammerer has to say, when he looks back at his life:

“As someone who commenced stuttering during early childhood, I developed a host

of strategies to protect myself from embarrassment. I avoided words that appeared

to cause me particular difficulty, and developed the expertise to (almost

unconsciously) substitute synonyms that I felt more confident in using. I became a

'walking thesaurus'. Habitual use of word substitution meant that I amassed an

extensive and varied vocabulary, which I put to good use in many different

situations.

My struggles with the spoken word encouraged me to cultivate useful writing skills.

In many instances, transferring my thoughts to paper was the only effective way in

which I could meaningfully express myself. The written option allowed me to

communicate exactly what I wanted to say...

Over the years, my writing skills have taken me in many interesting and exciting

directions. I have edited several magazines; held the secretaryship of numerous

organizations; and undertaken the role of advisor to a fictional crime series on

British television. I have also written humorous verse and other poetry. During

recent years, I have composed several poems about stuttering, which are used in

many parts of the world.

In addition, my slogans have enabled me to win hundreds of prizes (including cars

and exotic holidays) in consumer competitions. My reputation as a wordsmith has

also created many other opportunities. Over the years, I have been invited to

prepare speeches/poems for use by other people at a variety of events... “3

Does this happen to every PWS? No. But it can- if we, the stutterer, can take courage and

get the ball rolling. Neither God nor society can be held responsible for what has

happened to us. Therefore, it is we ourselves who can and should do something about it.

Once we begin, both God and society help us. For many of us, the first step is - to stop

feeling bad for ourselves, to get out of the bog of self-pity. This is a huge task and few

attempt it on their own. Many have found Self help groups, whether physical or web-

based, which is a good place to undertake this first major step on the road to recovery.

As we walk, this road full of ups and downs, we discover that Nature is constituted on the

principle of duality. Every phenomena has an obverse and reverse aspect. Our disability is

no exception. What we had considered for a long time to be our 'weakness' is our

'strength' too. It just needs a little shift in our perception. These little 'shifts' come during

stress- for example a bungled interview: An interview where we knew the subject matter

very well, but made a mess while replying to a simple question (what is your name?); the

panel asked no further questions and asked us to leave. When something like this

happens, let us stop to think and review our communication and our coping strategies,

instead of blaming others, fate etc.

Stammering has another explanation. It is an exaggerated reaction to 'perceived' threat,

manifesting through speech: Perceived threat- as opposed to 'real' threat. Our biology has

inherited three kinds of response to danger: fight, flight or freeze. When a PWS decides to

fight, he tends to tighten his chest and throat muscles and forces the word out, as if they

were a piece of cork, jammed in this throat. If he decides to fly away from threat, he uses

avoidance- like changing the word, the topic or even keeping quiet. Lastly, sometimes, the

fear of the approaching difficulty is so great, that we do nothing- we simply freeze in

terror- a silent block. Our thoughts, speech, breathing- everything freezes for those

moments, which appear to be never ending.

3 Alan Badmington, member, British Stammering Association

We can see that all three responses do not really help the process of communication. But

how can we change these knee-jerk reactions? It is like re-living a moment of great

danger faced by one of our hunter-gatherer ancestors ages ago: She was happily picking

berries in a bush and suddenly she was face to face with an angry bear! Can you think

rationally at such moments? You dont think. You just react at such moments.

But there is a way out. In our case, most often the bear is not there or if it is there it is

certainly not angry! Our body is reacting to a threat, which is actually an interpretation (if

not pure imagination) put together by our mind. Can we retrain our mind to interpret

outer reality in a different way? Yes, we can. Imagine, our young PWS going back to the

interview, but with a different set of thoughts in his head:

“..This is just an interview- not a matter of life and death. There will be many more

interviews beyond this. I will never stop until I succeed. Moreover, I know my

subject well . Even if I stumble on a word, I will get back into communication mode

and explain what I am trying to say. The people out there in the interview panel are

looking for a good candidate, which I am... So, whatever is the outcome of this

interview, It is fine by me...

So, if he goes to the interview, with such thoughts, chances are he will stammer very little

and will be able to get his point across. He might even get selected like many PWS all over

and every year. This is called 'cognitive restructuring' in the West and 'positive thinking' in

the East. It can be cultivated through deep and regular meditation and positive self talk

(reaffirmations).

So, essentially, we can act differently, only if we can think and feel differently- about

speech, communication, self and others. You can think and feel differently only if you can

become a different person. The most stable and significant changes come from within, to

without. Such changes improve not only our communication, but everything else. A time

comes when even we ourselves marvel at the person we have become! Do you believe

this?

Beyond Stuttering: Deeper Issues of Life

Here is the testimony of an 'internalized' (covert) stutterer:

For many years, I did not know- for sure- who I was. Sometime I stammered

uncontrollably- sometime I spoke normally, even fluently. Was I a stutterer or was I

a normal person? This was a big question, I went to sleep with; and wondered

again every morning, as a child and adolescent. Stakes were high. And the world

responded differently to these two different kind of persons. Who was I? Whenever

I spoke, I was a little confused- am I going to stammer or am I going to speak

normally?

Sometimes, I will try to forcibly push this question out of my mind – and into the

subconscious- and will try to focus at the task at hand: speaking. Sometimes this

trick worked. So, I decided to disown my stammering self – leave it behind in a

dungeon of indifference, in a limbo. My motto was: if you want to speak like normal

people, BELIEVE that you are a normally speaking person! It worked for years- but

every once in a while, I will feel as if something is missing. Kunti may have felt it in

her latter years- because she too had disowned her son, Karna for years. Like Kunti

in the epic Mahabharat, one day, I too approached my stuttering self in the dark

dungeon- with understanding, compassion and acceptance.

Some more years passed by, and then, one day I said- of course I am beyond my

both stuttering self and fluent self. These are just two roles I am playing on this

world stage. My real Self, with a capital S, is beyond both and can never be

compromised by whatever the world grants or holds back..

This was the turning point in my life.. and a very 'spiritual' moment. There are

many ways to approach 'God'. I chose the stuttering way..

To many of us, stuttering has an ethical dimension. We are hiding something in every

social transaction. Is hiding our disfluency, same as hiding our bodies under clothes?

Immaterial? Is hiding our stammer same as hiding our income during an income tax

assessment? Which is more unethical? If so, who are we sinning against?

As we grow older, we understand, the fine difference: we do 'short change' our listeners,

when we try to pass off for a 'fluent' person, not our true selves- but he or she may not

hold it against us; they may not even notice it many times. But we do ourselves

considerable injustice in the process. We restrict our possibilities for growth and true

communication.

Now, how does one come out of this dilemma? A little humility and a lot of courage is

what one needs to step out of the conditioned responses. We need to ask ourselves, how

much do I allow myself to be influenced by society. Is there anything beyond the society

and the world, whose approval and acceptance should matter to me? This is how a

spiritual inquiry begins. If we persist we find answers not only to our stammering but to a

much deeper question: what is the purpose of my life? How do I make it more meaningful,

to myself?

TISA: Philosophy & Approach

‘..The way our “worthy” alcoholics have sometime tried to judge the “less worthy” is, as

we look back on it, rather comical. Imagine, if you can, one alcoholic judging another.. ‘

(A quote from Bill Wilson, from “Spirituality of Imperfection”)

Judge not: We have been judged for our speech. We have judged others similarly on

superficial grounds. Some of us, who stammered less have judged others who stammered

more. But “imperfection” is our nature and there is something quite “spiritual” about it,

provided we accept ourselves as we are; then, accepting others with their “imperfections”

comes easy. This is the basis of self help group movement. TISA’s mandate is to promote

self help groups - both the physical ones and the web based ones. Through such a

movement, which generates exchange of information, we hope to influence attitudes all

round- both of those who stutter and those who do not: “Better attitudes through

knowledge” - this is TISA’s motto.

Acceptance & Action: Information and acceptance is not enough. Affirmative action is

the final step which gives meaning to our journey out of our personal prisons of suffering.

So following three steps or affirmations constitute the guiding principles of TISA SHGs.

I accept my SELF with my STAMMER

I accept others who STAMMER

I will try my best to help myself and serve others who STAMMER

Acceptance does not mean that we do not seek and practice whatever therapy or self help

is available to us. It does not mean that we do not work at our communication, career,

attitude and relationships. It only means that we do not think less of ourselves when we

stammer and are not apologetic about it.

A safe environment: Self help groups provide a safe environment to explore our speech

and related emotions, beliefs and attitudes as well as a supportive atmosphere to practice

new skills. We also discover in a group that we are not alone, facing this problem. We feel

empowered to approach or invite others and talk to them about this little understood

problem. For children and adolescents, this support can be life changing.

Finally support group is not only to support us, who stutter but also to provide support to

our family members who may be passing through a difficult time because of our

communication difficulties. It can also be a venue for students of Speech pathology and

young SLPs to learn from PWS and share their skills. A good facilitator of SHG will also try

to extend the horizons of her or his group by inviting people suffering from other rare

disorders like Tourrette syndrome, Neurological Stammering, Albinism, Dyslexia etc. Such

cross-learning can help a group formulate its own advocacy efforts in the long run.

Structure : TISA currently is an association of individual PWS from different parts of

country. We are in touch with each other through web, phone and personal meetings. Our

current focus is on functional groups led by individuals of exceptional motivation and

organizational skills- rather than a physical organization concentrated in one place. These

individuals are nominated as the Coordinator of the regional chapters (state or city based).

These regional chapters are encouraged to raise local contributions and use it to promote

SHG movement and better understanding of stammering in general public. At national

level, there is a two person Coordination team currently. TISA is at an early stage of

evolution and if we get more volunteers, these posts will be rotated over next three years.

We are looking for more PWS to join the core team- people with skills and experience of

advocacy / legal action, fund raising, media campaigns, writing and translation etc.

Members: TISA has some NRI PWS too as our core group members. More such NRIs are

welcome. PWS, who practice as SLPs or Speech counselors too are welcome. People who

do not stammer, but have promoted better understanding of our issues will always be

welcome to join as honorary / special members. Family members of PWS are also welcome

to join TISA. People promoting or representing commercial interest (drugs or electronic

aids) or exclusive therapy groups, should not be invited to TISA meetings, since TISA is all

about self help based on altruism.

Working with SLPs: TISA values and wishes to work with selected SLPs across the

country but on fair and transparent terms; the current fee structure and therapy schedules

are obviously un-sustainable for an average PWS in India. New modalities need to be

worked out. Secondly, many therapists make situation worse by claiming that stammering

is ‘curable’. Modern research disproves such claims. And those who continue to stammer

openly are made to feel bad, because the society is led to believe that this person is too

lazy to work on his speech, that is why he or she still continues to stammer. SLPs should

have the courage and honesty to say that there is no known ‘cure’ but yes, successful

management can be learned.

An Indian Organization: Even though we are an Indian association, we are in touch

with other national stammering associations, and wish to record our thanks to

International Stammering Association (ISA) for the help it extended to TISA in the

formative years (2006-07) through valuable services of Mr Keith Boss.

TISA blog is our public notice board, announcing regional meetings, advocacy campaigns

and sharing general information:

http://t-tisa.blogspot.com/

The chat group where TISA offers more specific counseling, self help material and other

specific information for PWS is located at Yahoo:

http://health.groups.yahoo.com/group/IndianPWS

Financing: If you appreciate the efforts done by TISA, make a contribution to the local

chapter and do ask for a progress report! Some of the major activities which need funds

urgently are:

Media campaigns (to change attitudes through sharing of correct information);

Observation of 22nd October (International Stammering awareness Day)

Travel and logistics for young PWS to participate in SHG in nearby cities;

2-3 day intensive residential camps for PWS.

Translation and publication of informational booklets and pamphlets on stammering

Production of educational video projects dealing objectively with stammering

Regional meets, inviting Speech pathology experts, educationists, media and policy

makers to take affirmative steps

Let us conclude with a thought from Aesop, who stammered and left behind many tales of

wisdom: What you think is not enough: what you do, however, does change your today

and influences your tomorrow..

Feedback: sachin at satksri@rediffmail.com, satksri@gmail.com,Phone +91(0)9412058272