Canadian Association for People who Stutter

CAPS Ottawa '93 Conference
July 29 - August 1, 1993

KEYNOTE ADDRESS AUGUST 1, 1993
DREAM THE IMPOSSIBLE DREAM

DR. JOCK A. CARLISLE

Summary prepared by Jaan Pill

Hello, there, everybody.

I can see in the audience a lot of old stuttering friends, and I can see a lot of, I won't say old, old therapists, but there are therapists here.

I always, when I start off with this kind of thing, I always say I am not a speech therapist, I'm not going to instruct you in speech therapy -- because there's always one speech therapist somewhere in the audience who says, "Hey, what are you talking about?"

I am going to talk about the thing that interests me, and it is myself, my favourite subject.

Earlier on, when I was unable to speak, or hardly speak at all, I always had at the back of my mind a dream -- a dream of being able to stand up here on a platform and speak to audiences. This has taken a long, long, long time.

I also -- earlier on -- I had a very severe stutter. It was the kind of stutter, that I stuttered when I talked to people, when I was on my own, whether I spoke to animals, and I even stuttered when I was asleep -- which sounds ridiculous, but I did.

And I hadn't ever really had the experience of fluency. And I remember the first instance when I had that feeling of fluency. Very recently I was making a speech and I said, "That feeling of fluency is almost as good as the experience of making love." And somebody at the back of the audience said, "Hey, not quite!"

I think that I will aim at, I will aim at talking about all the different factors that helped me to become reasonably fluent.

First of all, I think early on when I was at school, we -- all of us -- when we were at school, we had anxieties, and one of the first things I learned at school was how to handle anxiety. And handling anxiety is a great help when you have a stutter, because whenever you stand up or try to speak to anybody, you are overwhelmed by anxiety.

And learning how to handle that anxiety has for me been the largest thing that I have ever had to handle.

I know I had a lot of speech therapy, some of it successful, some of it unsuccessful. But always, the success or the failure of the therapy depended on the amount of anxiety that I had.

Also, when I was at school, one learned various survival strategies. I'm sure you all had to survive at school. You either handled it with your fists or you handled it in other ways.

But I also found afterwards, when I was trying to handle my stuttering outside school, that this development of those survival strategies, I found very helpful indeed.

Early on I had all sorts of speech therapy. Some of it was the old style of walking around swinging your arms and speaking. And it did make you reasonably fluent, but you can't go around everywhere swinging your arms or doing this [demonstrates] with your hands.

Elocution

There was one person. He had me, very successfully, nice and easily fluent when I was crawling around his office on my hands and knees. And he said, "There you are, I have cured you." Well I said, "It's all very well but I can't go back to school and crawl around on my hands and knees all day long."

Then I went in the hands of various experts in elocution. And there was one fine old person, a great old man with long hair, and he had me every Thursday morning reciting "The Charge of the Light Brigade." Every week.

The trouble was, I never got any further than "half a league, half a league." I never even got to the third half-league. Anyway I had, early on, a severe stutter, but by the time I was 16 or 17 it was easing off a little. And then I had the experience of being involved in a war.

Anyone here who has been involved in war will realize it is not a good thing for speech therapy. You're under a certain amount of anxiety half the time.

And at the end of the war there was an accident. Well it wasn't an accident, because some German aimed it at me. But there was an accident and I was injured, and I was absolutely speechless. I could not say anything for a long time.

Even so, although having a stutter in a war has its obstacles and problems, it also has its entertaining moments. I'll give you one or two of these.

Once, there was an air raid on, and I was in a hole down in the ground, with someone else holding over my head a helmet, and things were exploding all around, and I was saying, "Oh, sh, sh, sh," and my friend said, "Shushing them won't help." And I said, "I'm not saying that. I'm trying to say, 'Oh shit.'"

Another anecdote involved a war story about coming across a woman, about the time of D Day, who happened to also be a person who stutters.

When Carlisle left the Royal Air Force, he was absolutely speechless.

Also I couldn't hear very well. And the conclusion of the RAF people was that I was, quite frankly, loony. So from the warmth of their heart they decided I should have therapy for my speech, and then therapy for my mind.

Highlands

The speech therapy he received then was "completely hopeless -- in fact it was harmful at the time." The therapy for his mind was "entertaining, interesting." At the end of it the psychoanalyst treating said "I was as healthy as he was."

After that I went to university. There wasn't anything awfully interesting that happened there. After that something happened which was really, really interesting for me.

Can a stutterer imagine, when he hasn't been able to speak for a long time, of being actually paid not to speak? Can you imagine that? Well that was what happened to me.

I was hired to carry out a survey in the highlands of Scotland. And the reason they hired me, they said, was not for my academic qualifications, which were all right but not outstanding, [but] because I was the only person they'd come across who didn't object to being alone for six whole years.

Can you imagine the joy of a stutterer not having to speak for six years? Anyway, it was during those six years, up in the mountains, that I really began to understand myself. Those of you who've seen the movie, Voices to Remember [by Condor Productions] can see that at one stage I thought it would be easy to end it all up there. And you can easily end it all up there, even when you don't want to, in the mountains.

But I really began to understand myself, my strengths, my weaknesses, and it was during those six years that I formed the personality that I have.

It gave me a great determination. It gave me great flexibility. It gave me the ability to adapt to every situation. It also made me a perfectionist in some ways. Because you were only allowed, in the mountains, one mistake, because that was your last one....

But always up there in the hills, I was dreaming about how I could speak fluently. Animals were up there, and I used to speak to the animals, stuttering even then on my own. I thought how nice it would be to be fluent.

Ann Meltzer

Then, after I had been there, after various other forms of employment -- Yeah, I'll talk just a little bit about one of those forms of employment. If anyone asked me the worst experiences I've had as a stutterer, the worst discrimination and brutality and cruelty, I would say without any second thoughts that it was at Oxford University. At Oxford University, where academia can be very, very cruel. And at Oxford you either did things the Oxford way, or you were prejudiced against. And having a stutter was not the Oxford way.

And I have since then -- I have not had such extreme experiences, but I've come to the conclusion that sometimes the more educated a person is, and the more successful they are, academically, the least tolerance they have for handicaps. I don't know if any other people have had this experience, but I just can't leave it out.

Right. After those experiences I came here to Canada, and my speech got worse and worse and worse. And I decided to really do something about therapy. And I heard of a dragon, a dragon in Ottawa. And her name was Ann Meltzer. She's sitting over there. So they told me this was the lady I should go and see. So I went and saw her. And we were talking last night, actually, and we both admitted we scared the hell out of each other.

And I believe that she was being helped at that time by a psychologist. And after she'd interviewed me the first time, she went home in the middle of the afternoon, and had a quiet nervous breakdown. Now I didn't think that I was as formidable as that, Ann, but you tell me I was and I don't know why.

I suppose because of all of the awful experiences I've had with therapy, I was a little hostile toward therapy, and therapists. In fact, not a little hostile: I hated them. But that's all over of course.

When I was in the hands of Ann -- and I must say Ann is a terrific, terrific therapist -- but at that stage I understood quite a lot about therapy, and Ann had just entered the field.

And I remember the first time I had a session with her, I went home to my wife and she said, "Well, how did it go?" And I said, "Well, she's a nice lady, but I'm not sure she knows what she's doing."

And the therapy with her, I won't say it was easy. It was a lot of hard work, a lot of anguish, but it was very successful -- successful up to a certain level. But when I ended it after four years, I still could not easily use a telephone. And I still could not stand up here, like this.

It wasn't that I was overly anxious about stuttering or speech -- it's just that I had associated the telephone with stuttering, and public speaking with stuttering for so, so long, that every time I saw a microphone, or saw a telephone, I stuttered inwardly before I began speaking.

And in spite of the fact that for some time at the hospital they tried to desensitize me -- they desensitized me to some extent, but I was only able to overcome the final hump of this with the instrument I have brought up here today, the [Edinburgh] Masker.

Now I'm not recommending the Masker for therapy. It's just an instrument which helps stutterers who've had a lot of therapy, and they can't take it any further -- to take them over that hump.

It helped me to desensitize this association I had with the telephone and stuttering, and the microphone and stuttering. I don't suggest that any of you go hurtling out and get yourself one. If you do, talk to your therapist first, and only if you've had a great deal of ordinary therapy. OK?

Right. Now, the achievement of a reasonable degree of fluency, it isn't only a question of therapy. I received help in other ways from lots of other people. I have to say at this stage I got a lot of help from my wife, who is in here, there she is hiding in the background. Stand up Joan, let's see you.

And how she managed to put up with my stutter, and my rather difficult personality over all these years I don't really know. But there were others also.

Mentors

Over my existence, I didn't realize it, but there were a number of m-e-n-t-o-r-s: mentors. And these were people who helped me from the warmth of their hearts, and some of them helped in the wrong way and some of them helped in the right way.

I think the first mentor I had was my father. My father would never talk to me about my speech, and I could hardly talk to him about it because I couldn't speak much.

But about then, he had a financial interest in a circus. It wasn't one of these circuses that go about the place. It was a standing one, you know, a large one. And several times he asked me to go along with him to see all the people there, at the circus.

So I went on elephants, I romped with clowns, I saw the dwarfs, all of these kinds of thing. Now these people who worked in the circus were very different people. Very special people.

And my father put over to me the idea that different people, special people, the dwarfs and others like that, were real people and nice, warm-hearted people, and they could be successful no matter how different they were.

And this helped me all the way through my life, in school, the Forces, and everywhere else, because I was never worried because I was different. I've never been a person who has conformed to ordinary, expected standards.

I've conformed when I've had to, in the Armed Forces, and for other reasons. Otherwise, I have almost deliberately made myself different from others. Whether that's a good idea or not I'm not sure but I found it helped.

Rock climbing

There is also another person, someone else who helped me, and he was the guy who instructed me in rock climbing. Now as you are aware in rock climbing you musn't make too many errors. And this person instructed me how to go up a vertical rock with hand holds -- high, high, high.

And he told me: "If you hold yourself up against it, the rock, you will fall off and you've had it. If you can summon the courage to push yourself away from it, and don't look down (you might have a heart attack) -- if you can push yourself away from it -- you will find it easier because you can see what's up ahead, and you can scheme it out.

"But if you're up against it, the face of the rock, you cannot see what's up ahead, and you begin to quake and quiver."

And he said: "I suggest you try the same approach with your speech. Not to hold your speech too close to your heart. Don't think of it all the time to the exclusion of everything else. Hold it off at arm's length, and try to see it as an integral part of everything else."

And that I always found very helpful, because before that, my stutter -- I had held it very intimately, and close to my heart. It excluded me from thinking about other things, and seeing it as an integral part.

All right, there are other ones who have helped me, but I'm not going to go into all that. I'll go on to a stage here, which after a period of being fairly serious, is a little more entertaining.

Tangled Tongue

There was the period after I had written The Tangled Tongue, the book. And the publishers rang me up and said, "Would you mind appearing once or twice on radio and television?" I said, "Oh sure," you know, off the top of my head. I mean if it was only once or twice, what the hell.

Well in fact within the next eight or ten weeks I was on 32 times. At one stage I was doing eight programs on one day. And I tell you that is not easy.

But I came to a conclusion after this -- because after that exposure to the television and the radio, my fluency and my confidence had increased 100 percent, just like that. And maybe I'd reached an idea [that] in the end of your therapy, if you can stand exposing yourself, to a certain extent so it scares the hell out of you, it can be good speech therapy. I don't know what my speech therapist will say about that, and never mind.

But the first time I went on television I thought I was going to die. Especially as he'd just told me I was going to be speaking to four million people. I thought all these four million people are looking at this stuttering fool on television.

But when I saw it afterwards, I wasn't so much concerned about my stuttering -- it was there -- but I thought what an ugly face I've got. I'd always had this image of myself as a handsome kind of guy, and this ugly mug looking at me from the television, I couldn't believe it.

The interesting things, I found, when I was on television, was those shows where there was a call-in. Now, those shows aren't easy for anyone, whether they've got ordinary speech or otherwise.

But I found to my happiness that I had a certain aptitude for this kind of thing. I think my wife will tell you that I have an argumentative side to my character, and it was delicious arguing over the radio or the television.

Now, you've got the most strange questions. There was a lady, who asked me, and she had a very heavy accent: "You have been speaking here for half an hour, and you are a fraud." And I said, "Madam, do tell me why."

She said, "You haven't stuttered once: you are a fraud." I said, "Well, madam, would you like me to stutter?" So I stuttered for her and she said, "That's much better!"

Anyway, there was another incident on television. And this was a very large one. It went out to the States, and all over the place. And I'd been all right, you know, I'd answered all the questions, and then the director of the television show said, "Now at the end I'd like you to say a little bit about your speech," and all this.

So I said a bit, and then at the cage at the back they started saying, "Five, four, three," you know how they do at the end -- and I blocked solidly. You know what the word I blocked on? "Fluency." I just got "F-f-f-f-"

And the guys doing the program at the back were going frantic. And I uttered "fluency" you see into this thing. And then I said, "You see, it was all right, I said 'fluency.'" And then the guy said: "You're still on the air."

But the strangest question I received when I was on the television [was when] a lady rang in, and she said, "Tell me, I'm interested, how has stuttering affected your sex life?" Well, I thought about this for a flash, but I'm pretty sharp on my feet. And I said, "Madam, I think I'll answer that by asking you a question: How much talking do you do during yours?"

And she put down the telephone with a click. I wonder why. I just don't know why.

OK. I think the hardest part I had for a long time was to accept to myself that I had a stutter. I stuttered furiously. I could hardly get a word out. But I never had the image of myself as a handicapped person.

And when others reacted to my speech I really thought there was something wrong with them -- there was something wrong with their perception of me. Because the perception I had of myself was not the perception the other people had of me.

And I realized for a long time, within the family even, I did not discuss my stutter, very much. And it was not that I was hiding it or anxious about it. In a funny way for me it didn't exist, and the hardest part for me was to say to myself "I'm a stutterer, it exists."

Now, because I didn't think it existed for a while, I didn't have speech therapy for a long, long time.

And I came up against a similar thing when someone -- I was talking to someone who couldn't hear. And every time you said something, he said, "Eh, eh, eh," you know how they do.

And I said, "Well, why don't you buy yourself a hearing aid? They're not that expensive." "Yeah, but," he said, "then everyone would know that I was deaf." "Well," I said, "everybody I know knows you're deaf, so what's the difference?"

But that is it. We try to hide it from ourselves, that we've got a stutter. But we deceive ourselves -- but we don't deceive anyone else.

And I know there are some therapists here today who asked the clients to be here at this meeting, and they wouldn't come, even with help, the cash help, and this is very odd and very strange.

But the fact is -- and this happens with a lot of self-help organizations -- is that once you join a self-help organization, you openly present yourself to the world as a stutterer.

And these people are not willing to do that, and they're not going to get very far with their speech therapy unless they admit their stutter to themselves, and their stutter to the rest of the world.

I wish -- you people here today are those who have managed to overcome this obstacle. You by being here, are willing to expose yourselves and say, "Look, I am a stutterer, and to heck with it."

I think this organization, and others, and I've said this before -- one of their focuses should be to try and reach out to those people who have this inhibition. It would not only help the people. It would help your subscription rate.

I think out there, there must be five times the number of people who have stutters than in here this morning. If only we could reach out to them and help them. And I don't know how -- and if anyone afterwards has any ideas on all this I would be very interested.

One of the reasons I go on television and radio is to try and reach these people in their homes, where they hide with their speech problems, and try to tell them to go to self-help groups and to get speech therapy.

I think to go to speech therapy they have to admit there's something wrong with their speech. And if they become a member of a self-help group, to say to the world: "I've got a stutter."

Now it's all very well for me to say I don't give a hoot who thinks I stutter. But I can remember a time when I would have been humiliated with the thought of the world knowing that I had a stutter -- even though the world did know I had a stutter.

I have now reached a stage where I am an unashamed member of the honourable clan of the tangled tongue. The membership has in it some very honourable members, and they're respected members, and I think that people here today, that I've met, all of you without exception, are such nice people. I'm not just saying this.

But stutterers, I've come across thousands of them, and they are usually nice people. And I've said before -- I'm not quite sure if they're nice because they stutter, or if they stutter because they're over-nice. And that gives us a little room for thought.

New Jersey

All right, before I end, I'm going to say thank you, firstly to my wife, who's been so helpful to me all through my life. Secondly, to the dragon who was hidden in her Ottawa cave, Ann Meltzer, who has been a great help to me all my life.

And I'd like to thank all the self-help organizations who have helped me overcome certain obstacles. The one particular one I think of was the Speak Easy organization down in New Jersey.

And once when I was over there they asked me to go on a platform, with a microphone, and I said, "Oh yes." And I went up and had a quiet nervous breakdown -- because it was the first time.

I had never been able to handle it. Speak Easy gave me the opportunity to stand up in front of an audience with a microphone, to an audience that was amiably disposed to me, and ever since then, you can't keep me away from the microphone. Anyway, that's almost all I have to say. People ask me from time to time, "Don't you have terrible, terrible regrets that you've always had a stutter?"

And I've said to them, "Well, yeah, there's been certain inconveniences and hardships." But I have answered this usually by saying, "But the stutter has made me the person I am. And I like the person I am, and it's managed to give me a rich life. And if, to have a stutter is the essential ingredient to all these things, then so be it."

Thank you very much.

CAPS Ottawa '93 Conference
July 29 - August 1, 1993

KEYNOTE ADDRESS JULY 31, 1993
STUTTERING THERAPY: IS IT THE RIGHT SIDE OF THE BRAIN,
THE LEFT SIDE, OR IS IT THE HEART?

GERALD F. JOHNSON, Ph.D. CCC SLP/A
PROFESSOR EMERITUS, SCHOOL OF COMMUNICATIVE DISORDERS
UNIVERSITY OF WISCONSIN - STEVENS POINT
EXECUTIVE DIRECTOR,
AMERICAN INSTITUTE FOR THE MANAGEMENT OF STUTTERING

Summary prepared by Jaan Pill

Gerald Johnson remarked that he had known Al Utronki for many years, having met him at many American conferences: "I respect him an awful lot for what I think are the necessary ingredients to be a successful stutterer, namely stamina, guts, interest in getting better, a sense of humour, and most of all a lot of heart." He added that he would be slipping in and out of using the terms people who stutter and stutterer. He added: "It's also a real pleasure to be here to celebrate the second meeting. Your two chairpersons, Norm and Richard, deserve an awful lot of praise. They've done a heck of a job." Al had made reference to my spouse, and I'd like her to stand up. Maxine. Long suffering I must say.

My presentation is going to be pragmatic -- and I hope challenging. I have said to my students over the years: at the end of the hour, if you come away with one idea, one thing, that's great. You don't have to remember everything, but if you hang your hat on one thing, that's enough. And I hope at the end of my hour or so, that you'll be able to at least come away with one idea.

He remarked, with reference to Marie Poulos, that the speech-language pathologists in the audience had been extremely privileged in the morning to witness evidence in favour of not maintaining an emotional distance "between yourself and the individual with whom you work." He added -- and please note that some of the following is paraphrased and is not a direct quote:

The more emotionally involved you are, I think in my heart, the more successful the therapy is going to be that you do with individuals who are in need.

Now I'd like a show of hands: how many of you consider yourselves hard-core stutterers, dyed in the wool?

Welcome, brothers and sisters!

Maxine said, "Now don't get up there and preach. You're a frustrated preacher; now you've got to get rid of that." But you've already seen some of that already.

One last little remark is that I hope someday that our field, and the support groups, self-help groups, whatever you refer to yourselves as, can finally get together and figure out what the hell makes us tick.

You have an excellent resource person in your midst, Jaan Pill, who is going to do a superb job, I know, in this unification effort. And I hope as he might meet with any of you, and ask you for input, help, assistance, etc, that you work with him. Jaan, you're here somewhere, are you not?

The title of my presentation is, "Stuttering therapy: is it the right brain, the left brain, or is it the heart?" Hopefully, we'll be able to find out.

But before I do this I'd like to get a little audience participation from you, and to start this out, what I'd like you to do is keep track of what I ask you to do. No right or wrong answer.

Would you all stand up, please. Turn in a circle.

Now make note whether you turned right or left. Pretend you look through a single-lens eyeglass. Note what eye. Now sit down. Pretend you'll take off one of your shoes. Recall whether you took off your left or right show.

How many of you always turned the same way in all the exercises? Did you always turn right? Left?

Now what I'd like you to do with the chair in front, take two index fingers, like this [demonstrates], and start to tap, till you go faster and faster and can't do it any more. How many of you stayed in sync?

All of these activities are controlled by messages sent by the brain. We function differently. Not all of us turn to the right. Not all of us were consistent in turning to the right, not all of us stayed in sync.

Now if we then lined you all up and took you one by one and did an analysis of your stuttering, we'd probably find a very broad range of stuttering, wouldn't we?

You all would not stutter equally. Some would stutter more, some less. Some of you would have many associated stuttering behaviours. Some of you might have very few.

And by the way, it aggravates me that so few of you stutter, who stutter. Come on, now, you're hiding something. Let's get it all out there. Let's wing it a little bit. You're all doing a great job! I think the word "stutter" is a misnomer when I come to groups like this, and I have over the year -- Just keep it up. You're doing a great job.

BRAIN WARS

The brain variables are mind-boggling. Now you know why I have coined the term "brain wars," to refer to persons who stutter.

Some of you have a bigger war than others. Your right brain may be more powerful than your left brain, and vice versa.

Are those of you who stutter more left-brain oriented than right? How many of you who are hard-core stutterers can sing without stuttering, talk to the animals without stuttering, whisper? How many of you can yell at your spouse without stuttering?

Now where are we in this big scheme of things anyway? Over 60 years ago it was postulated that the brain was confused in persons who stutter. Sixty years ago, and I'm sure many years before that -- and research continues to this day to map the brain's landscape, and to discover more about these brain wars. I wonder if we might look into the future, then, just a little bit. I'm wondering whether in 10 years a person who stutters is going to seek out a speech and language pathologist for service.

Instead, you will seek out a neurologist, who will do real-time mapping, while you're being tested at rest, doing various listening and motor activities, while mouthing speech without voice, while whispering, while singing, while reciting a well-learned poem or rhyme or joke, anything similar to that -- and while speaking under varying degrees of communicative stress.

Now this is stress, communicative stress, in the analysis.

A little side story here. It's not funny. The morning that we left, I had a message to phone a mother of a three-year-old son who has a stutter, and she was absolutely confused.

She went to one speech and language pathologist who said, "Your son stutters. He needs four therapy sessions a week." She went to a school speech and language pathologist who says, "Well, I can't find anything. We can't provide service. You son's not stuttering."

The mother was on the verge of tears, trying to find out what was going on. Well you can well appreciate what I said to the mother, aside from a few expletives, and anger and frustration that I shared with her about the inability of the speech and language pathologists to come up with a differential diagnosis.

You can't assess a person's stuttering without putting that person through communicative stress. I don't care how young the kid is, just tell the mother that you're going to do it. But you can't just bring the kid into this nice, nifty, unique environment and then expect the kid to do what he does every single day.

So anyway, when you go to this neurologist, after he or she has analyzed all of these and other variables, you're going to be taken into the brain laboratory, and there's gonna be Boris Karloff. And you all remember Boris Karloff -- and he's gonna zap a specific, pinpointed zone of your brain, and you're not gonna stutter any more. No applause for that?

Or, a pharmacologist who is going to administer, once a day, a brain blocker, and you will not stutter any more.

Farfetched? You're gonna have the option, then, of getting zapped, of being drugged, or being loved? And you know who's going to do the loving: the speech and language pathologist.

In the meantime, then, what are we left with? You all know the speech and language pathologists are not brain surgeons or pharmacologists. We are behaviourists. We analyze the stuttering behaviour and we treat it.

Now I ask you a rhetorical question. Is this a lesser therapy for brain wars? I would suggest that it is not.

Gerald Johnson noted at this point that most stuttering therapies used today are successful, but not with every person who stutters. He cited the example of a woman who was unable to avoid stuttering even when she was silently mouthing words. The woman had a powerful neurological dysfunction that behavioral types of therapy can't regulate. Johnson added:

I personally do not care anything about success statistics that some speech and language pathologists use to prove their worth. I don't care if you can so-called cure 80 percent, 85 percent [of your clients].

The ones that are still floating around out there, that don't seem to fit the cure statistics, are the ones that constantly haunt you, that bother you enough that you keep on striving to perfect the heart.

Enter the heart. Certainly there's much more to behaviouristic therapy than just sitting in a little room, reciting syllables, counting lengths of syllable stretch, and all the rest of that.

There's a lot of excess baggage being carried around. I'd like to talk, in the remaining few minutes that I have available to me, about the heart, about behaviouristic kinds of treatment, because that's what we do now.

Envy

Johnson described envy -- comparisons with other persons who stutter who have been in therapy -- as the first excess baggage.

The second was imperfection: "I think it's important to deal with imperfection. And I think the way to deal with it is to tolerate it."

Well, does that mean that we're going to create a happy stutterer? No, I don't think so. But in many therapies we're still confronted with the stuttering residual. You've gone through successful stuttering therapy, but as we have discovered throughout this meeting, there is a stuttering residual. That's an imperfection. If it drives you up a wall, drives you crazy, then you're gonna have to find a way to tolerate that.

Johnson also spoke about the need to deal with intimidation, the kind that comes from within. He referred as well to what he termed APR, or Anticipatory Panic Response, which increases the negative emotional energy that goes into stuttering.

In the 1960s, said Johnson, Joseph Sheehan spoke of this as Fight or Flight, within the context of the approach-avoidance theory of stuttering: "Should I, shouldn't I? Can I, can't I? This anticipatory panic response is something that takes a lot of heart to combat."

Johnson also spoke about being obsessive about stuttering -- and about the role of intensity of effort:

No pain, no gain. I remember the first assignment that Van Riper ever gave to the people in his therapy, and that was to stutter freely, openly, without embarrassment, shame, guilt, hostility.... I never had a better experience in stuttering therapy than I had doing that.

Johnson also offered an anecdote about an early stuttering episode during which he attempted to say something to another person in a therapy group. He began to struggle with a stuttered word just before a break. He continued as the two walked down the hallway, down the stairs, and outside the building. Finally, his listener turned to him and said: "Johnson, I don't think you're ever gonna get that word out."

Gerald Johnson also spoke of the importance of personal satisfaction:

Make an accommodation with yourself. If you can make an accommodation with yourself first, you can make an accommodation with anybody.

You gotta remember that life is just a click on the clock. The last moment is gone forever: you can never reclaim that, no matter how hard you want to try. Move on to the next event.

[We] went down the hallway and outside and: "Johnson, you'll never get the word out." Well if I had stopped there I wouldn't be here today.

You gotta keep moving, you gotta keep going, you gotta have that forward-moving spirit. Don't look back, as Sachel Page, the famous baseball pitcher many years ago, he says: "Don't look back, because something may be gaining on you." I think it's important to keep looking ahead.

He also talked of monitoring:

Monitor or not to monitor? That's the question. When your anticipatory panic response is pretty high, you're gonna have to tune in. When your anticipatory panic response is low, you will not have to do as much monitoring.

In other words, don't [monitor]. Don't do it. Develop a degree of spontaneity that allows you to talk fluently, which is what most of you do most of the time anyway. And you can reserve your energy to when that anticipatory panic response is pretty high. Gerald Johnson also spoke of the myth of stutter-free speech, and referred to Ted Peters' earlier anecdote about the fact that Charles Van Riper expected to be stuttering until the day he died. Johnson continued the anecdote with a discussion at heaven's door between Van Riper and St. Peter, who says:

"I got some good news and bad news for you." Well, Van Riper says, "Give me the good news first. I can handle that pretty well." "Well, Dr. Van, the good news is: You're not gonna stutter any more." "Oh wow!" He was pleased about that.

"Well, OK, now that I've had the good news, what's the bad news?" He says, "Well, Dr. Van, sorry to tell you, but you're dead!"

Assets and Liabilities

Johnson spoke next of "going through the heart," which involves undertaking an objective self-analysis. He asks his clients to make out a list of assets and liabilities. He spoke of a woman he had worked with who initially could not think of any assets, but who'd thought a lot about liabilities.

He cited the example of another woman who reported that her husband did not know that she stuttered until four or five years into the marriage.

Johnson spoke as well of objective self-analysis.

I have people put their assets on cards. The best asset, I say, tack it up around the house. Tack it up. Look at it, look at it. Then take one of your assets on another card and carry it around during the week, but look at it about four or five times a week, and believe in it....

What do you do with the liabilities? Put them on your cards. Analyze them. Are they liabilities?... Take these liabilities and figure out if they're causal, cause-and-effect relationships to stuttering. How can you modify and change that liability? Start working. Objective self-analysis.

And I say if at the end of the week you have taken care of that liability, what I want you to do is I want you to burn it. Take it outside, light a match, and then as it's burning you let out a Tarzan yell! You know how to make a Tarzan yell? C'mon, ready, one to three, go!

Any of the liabilities that you can't solve, put them aside. Hey, remember we've talked briefly about imperfections. You don't want to be perfect anyway. That's not a lot of fun, to be that.

Next is: Develop rational thinking. How realistic, objective, honest, and forthright are you with yourself?

Johnson remarked as an aside that one of the most helpful techniques in stuttering therapy is to maintain eye contact:

I don't care what else you do. But if you maintain positive, relational, intercommunicative eye contact, your speech is going to improve no matter what else happens.

Next is: Work for philosophical change. We're loaded with anti-thoughts, anti-philosophies. I think the solution for this is taking risks. To risk your mind, your body, your spirit, and expose yourself to life's peaks and valleys....

Accept what cannot be changed, and break loose from what can be changed. Tie together your self-analysis, your rational thinking, with your expanded philosophy. Break loose and use the things that can be changed.

Later on I'll talk about a concept that I refer to as leaper/creeper. I know you're sitting on the edges of your chair waiting for that one.

Achieve spontaneity is next. Anticipation is your worst enemy. Risk-takers are spontaneous people. They let it all hang out, without guilt and doubt and inhibition. These people, then, are the leapers in our society. These leapers have jumped and discovered that spontaneity does not kill.

Our daughter, for many years studied opera, music, and theatre. She studied at Julliard. She had a Fullbright scholarship and studied opera overseas. Her friends were the most fun-type people that I've ever known in my life -- because they truly were leapers. There wasn't a creeper in the bunch.

They were spontaneous, they were risk-takers, they were fun. Spontaneity. If you have an obsession about stuttering, you're not going to be very spontaneous. If you're worried about always doing the right thing, and trying to please other people, you're not going to achieve spontaneity.

Next: Keep yourself healthy. I think it's important. Some people are vegetarians, some people are not. Whatever lifestyle you choose for yourself, try to keep yourself healthy. The one ingredient that foods do not give us, however, is well-power. And I'm a living example of that, I'm sure, but health is very important to us -- mental, spiritual.

Meditation. Relaxation. One of your speakers had a workshop on relaxation. There are all kinds of shortcuts to relaxation, and let me just take you through, briefly, what I consider to be a fairly decent relaxation process.

Gerald Johnson then described a relaxation technique and added:

If you wish to visualize about managing how you're talking, or speech technique or whatever it might be, do that. But I find that most people, once they walk out the door and they're back in their natural environment, the relaxation doesn't carry over too far or too long.

But for that period of time, while you're in that relaxing mode, and in that box, feel good about yourself.

Next: Achieve independence. Once you've gone through the sliding door and it closes behind you, keep on walking. Keep your head up, get that backbone stiff.

Imperfection is a terrible thing to carry around with you. It keeps us from gaining independence. Do you know why there are so many self-help books on the market, I'm OK, You're OK... [it] is because most of us go through life with our arms folded across our chest. And you know where we learn that? In early childhood. We were taught to inhibit our responses: by No, Don't, Be Careful. You open that door one more time and I'm gonna kill you.

The love doctors are all around us. It's water over the dam, but I think that the things that we're talking about, the heart, the expansion, the forward moving, the outwardness that we can project, is what's gonna take care of ourselves.

Next: Talk to yourself. Do you problem-solve by verbalizing out loud? Doesn't it drive people crazy when you can't figure something out and you start talking about it out loud, and they think, boy, you're nuts, or something? Talk to yourself. Give yourself a pep talk. Be gentle, compassionate, self-indulgent, caring, loving -- to yourself.

Ego power. Some people like to beat that out of us. Having an ego is not a negative concept. Doggone it! It's good to have an ego. You should have one. Maybe a little one. Maybe a big one. You can start with a little one and develop it. It's not self-gratification. It's not self-glorification. It's knowing who you are. People who stutter -- and I want to read this to you, because even if I wrote it I think it's all right:

People who stutter are one bunch of humanity who are humane. We are good listeners, empathetic, humanely humble, caring, deep-thinking, and downright good people.

Give yourself a hand. Amen! It's true. We spend a lifetime listening and worrying about others. Doggone it. Time to get within the skin sack, as Van Riper refers to it. It's your choice. You can do with it what you will.

MAP is the last one on my list. Monitor, Action, and Performance. You knew that was going to happen, didn't you? You can't just think about getting better, you gotta do something about it.

Now, when I use the term "monitor" I'm not just talking about air-flow stuff, or stretch or whatever techniques you have learned in your therapy. But remember to monitor your assets and liabilities too. And to take those into your system, your behavioral system.

Action and Performance: have a means of evaluating those. Don't develop a 10-point evaluation scale. A 3-pointer will do. How did you do? Did you try that behaviour in a real tough situation? Give yourself three stars for that one. Even if you didn't succeed as well as you would have like to, it took a heck of a lot of guts to do that, in that situation.

Action. Don't put off until tomorrow what you can do today. The world is filled with sayings like that. The counter-culture group is the other way. I read a little newspaper article in US Today while I was flying home from North Carolina, and it was all about slackers. Do you know what a slacker is? It's a person who doesn't give a damn -- about money, prestige, or any of that kind of stuff.

Three little words, and I'll end this course, and the people who are standing with my handouts will do so now. Three little words. The three little words are: Go for it.

I've enjoyed being here and I've enjoyed chatting with you. We have a few minutes left before we get a little additional audience participation. I have brought in a recording that we're just gonna hear a sample of, of a song sung by Gloria Estefan. I love it. It's beautiful. It tells about the kinds of things that we've talked about this morning.

I hope you like it. And if you feel like getting up and boogying a little bit you know that's OK too. But we'll hold off until the very end. Now I'd like to entertain any questions or comments that anybody might have.

CAPS Ottawa '93 Conference
July 29 - August 1, 1993

KEYNOTE ADDRESS JULY 30, 1993
CONFESSIONS OF A STUTTERING SPEECH-LANGUAGE PATHOLOGIST

DR. TED PETERS
PROFESSOR EMERITUS
UNIVERSITY OF WISCONSIN - EAU CLAIRE

Summary prepared by Jaan Pill

Ted Peters remarked that he and his wife have enjoyed Canada on many trips. They have visited all the provinces except Newfoundland.

Dr. Peters said his original title for the talk was "Confessions of a stuttering speech therapist," but that a title that was even more apt was "Recovery from stuttering: Some thoughts from an old stutterer." His main topics were:

o his own story;
o his experiences as a clinician; and
o his thoughts on strategies for adults who stutter.

Dr. Peters remarked that while the contemporary term is "person who stutters," he's been using the term "stutterer" for 25 or 30 years. "So if I occasionally use the word 'stutterer,' I hope I don't offend anybody."

He has come across the term PWS, the initials for "person who stutters." He said he's rather not be called a PWS -- which as an acronym is pronounced something like "pwuss." He said: "I'd rather be a stutterer than a 'pwuss.'"

Early history

Of his early years, Ted Peters noted that he began stuttering in his pre-school years. His first vivid memory is from age 7 or 8 when, one morning, his dad was shaving and Peters was talking about Christmas. He happened to stutter on the word "Christmas," and his father told him to say it again.

So I went "C-C-C-Christmas," and he said, "Now take your time," like we've all heard -- "Now think what you're gonna say." So again: "C-C-C-Christmas."

And I don't know, maybe the fifth or sixth time, I got the word out. Like we all know, if we say it enough times eventually it comes out okay.

And then he said, "That's good; that's the way it ought to be. Now say it once more and then you can go."

Well then I said, "C-C-C-Christmas," and the whole damn thing played itself out. And I remember ending up crying in that situation.

His father found it uncomfortable to have a son who stuttered. Peters remembers constantly being asked to say things over:

And it got to be I didn't like talking to Dad. And in fact if he'd come home from work, he'd say, "What did you do today, Ted?" and I'd say, "Nothing." Because that was easier than telling him and then going through all the correction.

And I think Dad must've figured he had a very dull kid, because he did nothing at all through his childhood. At least that's what I kept telling Dad. But I just didn't like that constant criticism. And it really soured our relationship, I think until the day Dad died.

Peters found his mother was more neutral or accepting. He added that from working with many people who stutter, he knew that many parents are very accepting of children who stutter, and sometimes it's the mother who might not be as accepting.

Peters grew up in a little country village in a very stable farming community. His school had three classrooms. He started Kindergarten with eight students and graduated with all of the same classmates in Grade 8. In the school, he doesn't remember ever being teased about his stuttering.

When he was about 8, his mother drove him to a house in Grand Rapids, Michigan and told him he was going to see a speech therapist. Peters recalled that:

I just still remember being scared, angry, upset, and I remember when we got into this woman's living room I started crying. I don't know whether it was the confrontation with my stuttering, but it took maybe a half hour for this woman to calm me down.

He never developed a close relationship with the therapist, who gave him lessons to practise, such as saying "Lee, Li, Lo, Lu" and "Me, My, Mo, Mu." He practised these 20 minutes a day on his own. He was also instructed to read short paragraphs. He spoke fine when practising on his own but there was no improvement in other speaking situations. After three or four months the lessons stopped.

A year or two later he was taken to a psychiatrist. Peters remembers lying to him a great deal, and trying to keep him away: "I didn't feel comfortable with this man. Or he didn't have the clinical skills to help me have confidence and to be open with him." In time these visits were also discontinued.

Then between his junior and senior year in high school, his parents hired Joe, a speech therapist who was completing his Master's degree with Charles Van Riper at Western Michigan University. The therapist attended school in the mornings and worked with Peters a couple of hours every afternoon, for one summer.

For a change, Peters felt comfortable with this therapist:

He seemed to accept me as I was. He seemed to accept my stuttering. I began to talk about my stuttering with him like I never could about it with anyone else.

And the other thing about Joe, he seemed to convey that he knew what to do about stuttering. Or how to help me. He had a very definite plan laid out that he shared with me.

The therapist applied Van Riper's stuttering-modification therapy. Much emphasis was put on starting to eliminate the avoiding of situations -- to "go ahead and talk in situations where you're afraid."

The therapy also emphasized eliminating the avoidance of feared words:

Give up those word substitutions. Give up those postponements. Give up the rephrasing of sentences, [where you try to] sneak your way around the feared words.

The therapy also focused on what Van Riper called desensitization. This involves toughening up to the stuttering, or being more open and accepting of it. Peters was instructed to begin to talk to people about stuttering -- "to get it out as a topic of discussion, which I had never done."

He also learned to do voluntary stuttering, or stuttering on purpose:

Put-put-put in some easy st-st-stuttering in your speech on purpose to find out that you could t-t-t-tolerate this thing that for years you were so a-f-f-f-fraid of.

That summer he worked with his therapist for an hour or two each day trying to sell can openers door to door: "I don't think that we sold more than one all summer, but this gave us a lot of talking experiences."

As well, Peters learned to modify the moment of stuttering -- to stutter in a more fluent fashion using techniques that Van Riper called pullouts and preparatory sets:

Instead of saying P-P-Peters [demonstrates while applying strong pressure on the P-P-Peters], I would learn to say P-P-P -- [at this point demonstrates a marked reduction of pressure] -- Peters, and sort of pull out of it easily.

Or if he sensed a feared word coming up in a sentence, he would approach that word easily, with a reduction in pressure in his speech musculature. The result was an easy, relaxed, slower, and more acceptable form of stuttering. Peters practised these techniques constantly during his door-to-door sales efforts.

By the end of that summer he was speaking well. He had a lot of fluency and he was handling his stutter well. But when he returned to school, in a different state, by Thanksgiving he was stuttering as badly as he had been in the spring.

Without the clinician, he stopped doing the things he had learned:

I could just feel the old fears coming back. The old avoidances began creeping in, the old battling-your-way-through-the-stutters: trying to jerk out of them.

He next enrolled at the University of Michigan, Ann Arbor, where a speech and hearing screening process lead to a suggestion that he again enroll in speech therapy.

Peters was one of four students in a therapy group conducted by a graduate student -- who appeared to feel uncomfortable about stuttering, and appeared not to know what to do about stuttering. The group quickly disbanded. Peters stayed at Michigan for four years, majoring in economics, but his stuttering was really getting in the way, socially and otherwise:

I couldn't participate in class. I really didn't know what the heck I'd be doing in a career. My grades were not particularly great. In fact eventually they asked me to leave, because my grade point got below a C average.

As an example of avoidance behaviours at this time in his life, Peters referred to meeting his future wife, Karen, at a New Year's Eve party. He was there with another young woman, and she was there with another date. He spoke with Karen for an hour and wanted to ask her for a date:

I learned subsequently that she was expecting me to call her for a date. Well next week there was no way I was going to get on to the telephone and risk stuttering when calling her for a date.

A year went by and again he met Karen at a New Year's party. Again, each turned up with their respective date:

Again I'd had something to drink, and again we met and talked for an hour or two. We got along beautifully. The next week I was not going to ask her for a date. I would not risk it and get on the phone. Six months later -- this was now a year and a half after our original meeting -- I had a mutual friend fix us up on a blind date. In other words he did all the phone calling and set it all up. I just had to show up. Well, that's a year-and-a-half avoidance behaviour. They subsequently began to date, and have now been married for 36 years.

Charles Van Riper

At the end of the four years at Michigan, Peters went to Western Michigan University and had therapy with Charles Van Riper himself. At that time Van Riper would have intensive group therapy, with seven or eight stutterers starting with therapy in the fall. They would meet three hours a day, five days a week for a semester.

There would be an hour of group therapy, then an hour of individual therapy, and then another hour of group therapy. A graduate clinician would be assigned to each client.

Again, the therapy focused on desensitization, voluntary stuttering, elimination of avoidance behaviour, and application of pullouts and preparatory sets. A typical assignment might involve spending an evening and the next morning talking to 50 people in Kalamazoo, Michigan, using at least two or three good pullouts or prep sets each time.

Peters was speaking well by the end of the semester. Karen and he got married and he began working for a company that manufactured school furniture. He worked a year and a half in an office in Grand Rapids, and a year in California as a furniture salesman.

Again he began to relapse. One time he was stuttering severely speaking with a school superintendent at the Edwards Air Force Base in California. When he left that meeting, he stopped his car in the Mohave Desert and said to himself the situation was becoming tiresome. He had been successful with treatment twice, and each time had experienced a relapse.

He decided to start doing therapy on his own. He began to give himself assignments, things that had worked in his two previous therapies.

His speech again improved, and he decided he did not wish to stay in a business career. He spoke with Van Riper, who suggested he return to university and major in speech therapy. Peter wrote to Michigan University, explained why he had flunked out, and within a week heard back that his last semester's work had been erased from his transcript.

Peters got a Bachelor's and a Master's degree at Western Michigan, and worked at a Veterans' Administration hospital and at a public school. Later he went to grad school at Michigan State.

By then Peters was speaking quite well, but there would be some situations where he would do some avoiding, and where he would not apply his pullouts and prep sets. He felt guilty because he could not use the controls well.

He also recalled some experiences during his early years as a speech therapist. One time the parents of a child with an articulation problem complained to a school principal that Peters himself had a speech problem. On another occasion, an aphasic patient at a Veteran's Hospital was startled at the thought that a speech therapist who stuttered was going to attempt to help the patient to re-learn how to speak.

At this time Peters met Joe Sheehan, who taught at the University of California, Los Angeles. Sheehan was associated with what was known as the approach-avoidance theory of stuttering. When he spoke with Peters at an ASHA cocktail party, Sheehan said Peters was right in eliminating the avoidance behaviour. But Sheehan added that: "You need to accept yourself as a stutterer." Peters quoted directly from Sheehan on this topic:

You are the same person, whether you stutter or not. There is nothing to be ashamed of when you stutter, and there is nothing to be proud of when you're fluent.

Peters admired another statement from Sheehan, which he believed was based on a quotation from Oscar Wilde:

He said there are two ways to be disappointed in this world. One way is to not get what you want. And the other way is to get what you want.

Peters added, "I think sometimes that's true with stuttering.... You've got to accept yourself as a person that has this propensity to stutter, but you're still you and you're still a good person, whether you have the stutter or not."

Sheehan's counsel diminished the guilt that Peters had sometimes felt when he couldn't control his stuttering. On this point Sheehan disagreed with Van Riper. He disagreed with Van Riper's strategy of using controls in such a way that the person sounds almost or completely fluent. Instead, you should let your listener know that you're modifying your stutters. Don't try to pass yourself off as a normal speaker.

Applying the advice from Sheehan -- being open about how he was modifying his speech -- Peters found that he was becoming more and more spontaneously fluent. When he did have stutters, he handled them more easily:

And for the last 25 years or so now, I've been talking pretty much like I talk here this morning. I have a lot of spontaneous fluency. There'll be times when I still have stutters, and I'll need to modify them. Sometimes I modify them pretty well; sometimes they'll get away from me.

He doesn't do much if any avoiding -- "I keep my red flag out for that" -- and he still gives himself assignments. For example, in the last several summers, getting close to retirement, he hasn't worked, and by the time school begins he'd find himself having more stutters in his speech. His assignments might involve, say, putting in 25 little voluntary stutters during breakfast with Karen.

Speech therapy with adults

After his doctorate from Michigan State, Peters took a position where for 25 years he has taught courses in stuttering, and supervised grad students working with stuttering.

Early in his work with adults who stutter, he followed Van Riper's and Sheehan's ideas. Then 15 or 20 years ago he studied the work of people like Bruce Ryan, Ron Webster, and Bill Perkins who were exponents of fluency-shaping therapy. Here a client learns fluency-initiating gestures, or fluency skills where a person might modify the whole speech pattern by:

o beginning a phrase with a very gentle onset
o slowing down the speech rate by stretching out the syllables
o possibly being more relaxed in the articulatory movements

Usually these skills are taught in a structured speech situation, possibly with single words and phrases, followed by working the speech pattern into conversations, within -- and later outside of -- the therapy room.

Peters began doing more of the fluency-shaping therapy. In his experience it works but has downfalls because of insufficient focus on desensitization, and on elimination of avoidances.

So he began to combine features of the two approaches, a strategy that had also occurred to Barry Guitar at the University of Vermont.

From the stuttering modification approach he took the emphasis on avoidance-elimination and desensitization. From fluency shaping he took the learning of fluency skills.

Peters added that the two approaches are compatible. He noted that Van Riper's approach of going easily into a feared word is similar to using a gentle onset. "Working through it in a relaxed fashion" (Van Riper) is similar to "stretching out the syllables" (fluency modification).

A key difference is that in stuttering modification, the strategy is applied on just the feared word, whereas in fluency shaping it's applied to the whole phrase, or sentence.

In terms of proprioceptive feedback -- the muscle movement that is involved -- you're doing the same thing; the only difference is in the unit of speech that you're applying it to.

When clients are trained in both approaches, said Peters, some like to go the stuttering-modification route while some take the other route. He added:

And some combine them. And I think when I noticed this would be at conventions like this [one], talking to people who stutter. Sometimes you can't tell if the person came through a fluency-shaping program or a stuttering-modification program -- because they're both using these slow, relaxed movements in their speech, and both slowing down.

And I think some fluency-shaping people end up not doing it on the whole sentence. They just do it when they need it, which makes it even more difficult to tell the therapy they come out of.

Joseph Sheehan

Overall, Peters said that motivation is "just terribly important -- changing the way you talk takes a lot of hard work." He added:

If you're choosing a therapy, I think it's important that you feel accepted, understood by your clinician. And I think you also need to feel that your clinician is competent.

Also, I think you should feel very, very, very, very free to ask your clinician all sorts of questions -- about what they do, about what you can expect from therapy, what sort of results they get. I think often I have seen people who stutter may be reluctant to ask enough questions.

Peters also emphasized the importance of:

Three goals that Peters recommended are:

He noted that a person can have each of these kinds of speech in a given day.

Spontaneous fluency is the speech of the normal speaker:

I suspect that all of you have spontaneous fluency sometimes -- talking to good friends, your spouse. An idea pops into your head and you just talk -- words come out. No controls, nothing like that. I think most people who stutter will have periods during any given day when they will be spontaneously fluent.

Controlled fluency involves sounding very much like a normal speaker, said Peters, but it will take some effort in applying stuttering-modification or fluency-shaping skills:

So you're going to sound pretty good but you're paying a price in terms of the effort, the psychological effort that you have to put in to sound that good. But it's nice to have that ability when you want to use it.

The third goal, said Peters, is what he calls acceptable stuttering, where sometimes a person does some stuttering and feels comfortable with it.

Ted Peters finished his keynote address with the earlier quote from Joe Sheehan:


Updated May 20th, 1996

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