The Tricks of the Trade

Avoidances - speak now, pay later

The stutterer sometimes needs to plan in detail in order to cope. Case history: Mr A is a clerk at a large banking institution. He works in an open-plan office with three colleagues and they share a telephone. Mr A has unobtrusively positioned his desk so that his colleagues sit closer to the telephone than he does and therefore answer most of the calls. Usually there are no problems, but there are times when he is the only one in the office. For Mr A this is an unbearable situation. As soon as it happens he leaves the office, ostensibly to go to the toilet.

This is known as avoidance behaviour. Avoidances can be very time-consuming, expensive and exhausting.

Word substitution - the use of an alternative word for one that is difficult to pronounce – also represents a type of avoidance. With skilful language substitution the listener will not easily become aware of the ‘brain gymnastics’ being performed by the speaker. But often the search for safe words fails. A sentence like ‘At what time are you going home?’ can still easily be changed to ‘When are you going home?’; but in other cases the stutterer may have to use peculiar language. A good example is that of the person who, instead of saying ‘at eleven’, speaks of ‘the hour after ten’ or ‘the hour before twelve’.

Language substitution can be a real hindrance. While fluent people can concentrate fully on the topic of conversation, the stutterer may have to search frantically for alternative phrasings. Another problem is that avoidances tend to reinforce speech fears.

As a result the general wisdom within the stuttering community is that you should not avoid. This is a good guideline, but should be qualified. Telling a stutterer not to avoid and to rather stutter, is like telling a soldier to fight without giving him a weapon. A stutterer should indeed not avoid – he should rather be taught a fluency technique and use it instead of stuttering. Requiring from the stutterer to face his fears without providing him the benefits of a fluency technique, may have the effect of increasing his fears, thus increasing the stress and causing more stuttering.

The consistent stutterer tends to use fewer avoidances. This is because the consistent stutterer has discovered that he will stutter anyway in spite of using synonyms and other gimmicks. Situational stutterers, ie those who only stutter in certain situations – and they seem to be in the majority – do have some fluency and can better hide their stuttering.

That does not mean that the life of the situational stutterer is necessarily easier than that of someone with a more severe, consistent stutter. The situational stutterer may lead a double life – that of both stutterer and fluent speaker – and is often not as well adapted to the defect as the consistent stutterer who stutters on almost every word. Because his speech can be so fluent, the public often finds it difficult to believe that the situational stutterer does in fact stutter.

Distractions and secondary stuttering behaviour

Through the ages stutterers have used distractions to improve their speech. Anything that distracts the attention for a moment from the feared approaching sound or word can break the block – possibly because, according to Martin Schwartz’s theory, the person’s tension level is momentarily lowered so that the vocal cords are released. Many stutterers will quickly touch an ear, scratch their head or blink just before speaking. It is seen as normal and socially acceptable behaviour. However, such gimmicks tend to become habits in themselves because the stutterer becomes so dependent on them.

What happens next is that the stutterer tends to use distractions of increasing strength because he has gradually become so used to the original distraction that it has lost its effectiveness. Unfortunately the stronger distraction is often more noticeable and consequently socially unacceptable. The initial innocent touching of the ear may turn into an apparently meaningless arm movement; the unobtrusive wink can become a tight closing of the eyes; what was formerly an unobserved foot movement becomes a dramatic stamp of the foot. In this way such unnatural behaviour, also known as secondary stuttering behaviour, becomes part of the whole stuttering problem.

Distractions can assume the strangest forms. Prof Schwartz writes of a patient who could only speak if he threw a pencil up in the air before starting a sentence. A fountain pen or ballpoint had no effect – it had to be a pencil!

Just about anything can serve as a distraction. Intense emotions such as anger or aggression can distract one’s attention; in fact some stutterers gradually ‘learn’ to act aggressively just to distract their attention from stuttering. The speech block in itself can also be a distraction. Some stutterers speak extremely fast to distract themselves – the mere speed of their speech distracts their attention from the feared words or sounds. But at the same time they become used to fast speech, which increases the burden on the vocal cords and results in ‘speed stress’ (see the chapter ‘A Possible Cause of Stuttering’).

One of the ironies of stuttering is that even tension, which usually makes stuttering particularly bad, may serve as a distraction. In his book The nature of stuttering Van Riper tells of one of his patients, a member of a submarine crew, who discovered a sudden fault in the machinery of the submarine. During this emergency he gave, much to his own surprise, a rapid series of orders under great pressure without getting stuck (although his hair apparently began to turn grey afterwards!). The severity of the crisis had prevented him from thinking about what he was saying ...

A speech therapist from the Netherlands remarked being struck by the fact that his patients had few speech problems during the time that Germany invaded his country (May 1940). During a three-week period in which the entire country was in chaos, his patients also stayed away from his consulting room. Gradually the situation stabilised and ordinary life was resumed.

When his patients returned, they more often than not said that their speech had been excellent during that period. One of them explained it this way:

What is happening now is of such magnitude that one’s personal problems seem insignificant. When the survival of one’s country is at stake, one’s personal difficulties become unimportant.

(P Faber, Achtergronden van stotteren en spreekangst, 1979)

Even a fluency technique taught to a stutterer by a therapist can serve as a distraction, resulting in a temporary improvement in his speech – not necessarily due to the effectiveness of the technique, but because it distracts his attention from feared sounds. This feature complicates the extent to which the effectiveness of techniques can be proved.

The lengths to which people will go to rid themselves of stuttering defy credibility. Schwartz writes of a patient who changed his entire environment for the purposes of distraction. He not only changed his name, but his employment and city of residence as well – the novelty distracted his attention from his speech. Naturally the improvement did not last long.

A distinction should be made between indirect or ‘psychological’ methods of overcoming blocks, for example distractions, and ‘physical’ methods.

For example, some stutterers cough or speak very loudly or shout to help them speak. These may be physical methods of forcibly opening the vocal cords. And those who use the last remnants of air in their lungs to speak without stuttering, are making use of the natural opening of the vocal cords immediately before breathing in – it is a physical fact that the vocal cords open as a first step in the process of breathing in.

And the explanation for the ability to speak fluently after swallowing, is that the vocal cords lock as one swallows to keep food out of the air passage. After swallowing the vocal cords open automatically so that normal breathing can resume. The stutterer therefore uses this normal opening reflex to neutralise vocal cord locking. Unfortunately these gimmicks are of limited use to the stutterer – they don’t always work, and can become a habit and part of the whole stuttering problem.

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