Sunday, March 12, 2017

Stuttering and the highly sensitive child (HSC)

Is hypersensitivity a factor in the onset of stuttering? More than 80% of people who stutter are HSPs (Highly Sensitive People), yet this fact is seldom discussed in stuttering groups - probably because it's not politically correct to talk about psychological issues in stuttering. So, a few words on HSPs, particularly highly sensitive children (HSC), as this personality trait is probably a major factor in a child beginning to stutter due to subconscious repressed emotions. I would guess that a hypersensitive, introverted child is more likely to repress his unacceptable emotions, thereby risking the onset of stuttering.
About 1/5 of the human population is hypersensitive, meaning that their sensory system (touch, sounds, etc.) is more finely attuned than others. On the upside, they tend to experience life more intensely and deeply - and many great artists, thinkers and other achievers are or were HSPs. On the downside it is easier for them to be overwhelmed by sensory stimuli, stress and life in general. Their fight / flight / freeze response is stronger, and anxiety, particularly social anxiety, is common. They are usually, but not always, introverts and shy - though they can overcome shyness - and they take longer to make decisions.

"Orchid children"

HSCs have been described as "orchid children". Like orchids, they can develop into extraordinary individuals if their sensitivity is taken into account. Hypersensitivity is an inherent trait and society should not try to change them, as they are not "abnormal". They tend to prefer quiet, slow, solitary and structured environments and value privacy, using "me-time" to reload their batteries, and they avoid noise and crowds, often wanting to stay at home rather than going out. Too many extramural activities should be avoided, and they prefer smaller parties rather than large gatherings. They like to be prepared for any change in routines, and prefer predictable outcomes rather than unpleasant surprises.
Stressful sports do not work for these children - they perform best in more solitary sports such as bicycle riding, long-distance running, rock climbing etc. Oral exams, asking questions in class etc. can be a nightmare for them.
The above facts are based on the advice of a leading occupational therapist here in South Africa, and I hope that it will assist caregivers in helping their highly sensitive children reach their full potential and perhaps reducing or even eliminating stuttering. Being an HSP myself I can attest to the value of these tips!
For more information on HSC, check out the following bestseller by the famous psychologist Dr Elaine Aron: The Highly Sensitive Child: Helping Our Children Thrive When The World Overwhelms Them (2002).

Thursday, February 16, 2017

Stuttering as a mindbody disorder

Stuttering as a mindbody disorder – basic information

By Peter Louw

(This is the basic info document from my "Stuttering as a mindbody disorder" Facebook group, which can be joined HERE. )

What is a mindbody disorder?

Modern views of mindbody disorders are based on the pioneering work of Dr John Sarno, MD (1923-). According to him, many ailments that are usually regarded as physical have their origin in the subconscious mind. This is actually a very old idea with a long tradition; but with the phenomenal rise and great successes of scientific medicine in the 20th century the concept of psychosomatic disorders, which in the 1940s was still an accepted part of medical studies, generally fell in disfavour within the medical establishment.

Today, Dr Sarno is generally regarded as the "father" of TMS (tension myositis syndrome, aka The Mindbody Syndrome). This is not (yet) an officially recognised medical condition, though various prominent doctors do acknowledge that it exists. In reality so many people have been healed by TMS treatment that there cannot be any doubt that TMS exists. The proof of the pudding lies in the eating. Need proof? Just read the hundreds of Amazon readers' reviews of Dr Sarno's best known book, Healing Back Pain:

It would seem that some people have a tendency to channel or direct their stress to a particular part of the body, which then experiences pain or some other disorder. The body part could be the neck (neck pain), lower or upper back (back pain), stomach (ulcers, heartburn), colon (spastic colon), the head (certain headaches / migraines), the nose (sinus issues), eyes (dry eyes), hands (carpal tunnel syndrome), legs (e.g. night muscle cramps), skin (certain skin disorders), "growing pains", eating disorders, chronic fatigue syndrome etc. Even some psychological disorders such as anxiety and depression may have their primary cause in the subconscious.

From a TMS point of view, more and more health issues that used to be regarded as purely physiological / neurological are being suspected of having an underlying subconscious cause. Have a look at this list of suspect ailments in the TMS Wiki:

Within the TMS community, stuttering is also frequently regarded as a type of TMS. In 2011, Dr Howard Schubiner MD, a TMS practitioner, wrote a short article in which he analysed the movie The King's Speech from a TMS viewpoint (read his article further below).

Two factors apparently shared by both stuttering and TMS make me think that stuttering could indeed be related to TMS:

1) Some kind of stress or tension.

2)  A spasm or cramp in the affected area, resulting in pain (e.g. back pain) or other disturbance. Dr Sarno believes that these spasms (often muscle spasms) are caused by slight hypoxia (reduction of oxygen) within the affected area and that the subconscious creates this hypoxia via the central nervous system. Is it far-fetched to think that this also happens to the muscles of the vocal cords of people who stutter? In this connection I refer to the work of Dr Martin F. Schwartz, who has devoted a great deal of his life to the hypothesis that stuttering is preceded by a tension-related "locking" or "freeze" of the vocal-cord muscles.

Incidentally, this hypoxia hypothesis is supported by recent research which found reduced blood flow to the speech centres of the brain during moments of stuttering. Perhaps the central nervous system reduces blood flow and creates mild hypoxia within the speech centres, thereby messing them up and resulting in the dyscoordination of the vocal-cord muscles, resulting in stuttering? Here is the link to the blood flow research:

What is the cause of a mindbody disorder?

It is believed that some people more than others are genetically predisposed toward developing TMS.

Dr Sarno believes that TMS is caused by a conflict, or mis-alignment, between the conscious and the subconscious. Strongly influenced by Dr Sigmund Freud, the father of psychoanalysis, Dr Sarno regards repressed feelings as a crucial factor in TMS. Anger / rage in particular is the usual suspect, but sadness, loneliness, fear, shame and guilt are also often identified as causing or increasing TMS. As I understand Sarno, the primitive part of the central nervous system regards these feelings as threatening, tries to make them go away and represses them, and can even, in predisposed individuals, create physical symptoms in an effort to distract the conscious mind away from the inner turmoil. For the primitive inner child-animal (the "id" in Freudian terms), happiness and survival are priorities, and these priorities are threatened by strong emotions that could upset the status quo. 
Other TMS experts regard the external symptoms as the voice of the subconscious, primitive inner child-animal part of the brain. We all have an inner child / animal, whose primitive needs are often ignored in our busy daily mature lives. If severely ignored, the inner child-animal may become enraged – not unlike a real child or animal! – and lash out in the form of TMS. Note that this inner rage can be quite substantial … like a slumbering volcano or a sleeping but ferocious wolf. Don't underestimate it!

How is TMS treated?

Healing, not surprisingly, entails becoming aware of such repressed feelings, continuously discharging them and bringing them out into consciousness. This should reduce the large "pool" of rage and other emotional energy accumulated within the subconscious through the years.

In many cases, merely READING a TMS book has cured some TMS sufferers. This is what is called "knowledge therapy" – when the individual becomes aware of the subconscious emotional origins of their symptoms, the symptoms often disappear as the subconscious realises that its trickery has been "found out". So it stops trying to distract the person via the symptoms.

In most cases, however, the subconscious mind needs more convincing before it will stop its mischief. Usually there are two phases: Firstly the CONSCIOUS mind needs to be totally convinced that the symptoms, though absolutely real and not a figment of the imagination, are being produced through the central nervous system with the purpose of distracting you from the actual inner conflict (which the primitive subconscious regards as more threatening to the individual's wellbeing than the TMS symptoms). Secondly – and most importantly – the SUBCONSCIOUS mind, too, needs to be convinced.

All this convincing can be done through reading TMS books, Facebook discussions (join the TMS Facebook group! – address below), introspection / self-talk, and journalling (writing about your issues in a diary / blog / Facebook etc.). Journalling especially is a major tool in TMS treatment. The more you do this, the deeper these concepts will sink into your subconscious, where true healing occurs. If the subconscious at last realises that its distractions have been discovered, it tends to stop its distractive efforts. For those who wish to do TMS exercises – the TMS Wiki has a free online procedure (see below for the address), while several books also provide similar procedures (see below). Severe cases may also find outside support and counselling helpful, such as from a trained mindbody doctor / practitioner (if you can find them in your area!).

Can all this help people who stutter?  

If stuttering is a type of TMS, as many TMS sufferers believe, there should be no reason why TMS treatment cannot help people who stutter. Read the TMS literature (and do any exercises) as if it applies to stuttering.

Dr Howard Schubiner MD believes that stuttering is indeed a type of TMS. Read his short article here:

Applied to stuttering, I would think that the following ten TMS healing principles would be useful:

1) Start reading! It's what Dr Sarno calls "knowledge therapy". Read at least ONE of the books on TMS mentioned below, as if it also applies to stuttering. Even better: read it TWICE! Or else read two books. The more the better! Allow these ideas to SINK IN DEEPLY into the subconscious, where the healing process begins.

2) As far as possible, don't let any stuttering worry you. In terms of TMS theory, the "purpose" of the stuttering blocks is to keep your mind occupied with physical symptoms, such as stuttering, distracting you from repressed emotions that threaten to come to the surface. Don't over-worry about the blocks / stuttering,  because that's exactly what TMS wants – it wants you to think about stuttering as a physical, neurological issue; it DOESN'T want you to begin thinking about any inner emotional issues. So try to identify any hidden emotions that might actually be behind the stutter.

3)  Beware of perfectionism! Many people who stutter are also perfectionists, and so are TMS sufferers. Perfectionism is highly enraging to the inner child-animal (which can be compared to a lazy couch potato who loves pleasure and beer and hates discipline – great excuse to let your hair down … J ). You must do everything in your power to avoid perfectionism which just feeds subconscious rage. Goodism, the tendency to be as ethical and moral as possible, is also a form of perfectionism.

4) Work on being (or becoming) assertive. Assertiveness can be seen as a mild and socially acceptable form of aggression. By being assertive you will discharge some of the inner rage which may be feeding your stutter. For a short summary of assertiveness as a tool in improving fluency, check out the following chapter of my free online book, Coping with Stuttering: .  And for an excellent TED talk on how a few assertive body positions will actually change your body chemistry to make you more relaxed and assertive, check out the following:

5) Begin working on those hidden emotions; identify them and allow them to come out into the open. Get in touch with your feelings. Journalling and similar involvement (mentioned above) should greatly help you in this. If necessary, try the TMS Recovery Program (see below) or other support mentioned below.

6) Don't regard the TMS – the stutter – as the enemy which should be fought at all costs. Stuttering is your inner child's primitive voice. Listen to its message and learn from it. Soothe and pamper the inner child. Once you have understood the message, the voice should fade.

7) The TMS explanation is not for everybody, and many if not most people will reject it. Partly this is because, for many people, it is easier to deal with physical, socially acceptable symptoms than with the underlying psychological pain.

8) Should we continue using fluency techniques, such as Slow Speech and Passive Airflow? Dr Sarno would say that such techniques address the overt symptoms, but not the psychological cause. Earlier in his practice he did make use of physiotherapists to deal with the TMS-related pains of his patients; but later he let the therapists go, instead focusing exclusively on the psychological pain which causes symptoms. 

Having said that, he does approve the limited use of painkillers when necessary in the case of e.g. severe back pain. I would say it's up to the stuttering individual whether to use fluency techniques or not if this makes life easier; but always keeping in mind that such techniques merely provide symptomatic relief and do not address the true cause. The same probably goes for other adjuncts such as stress management and stress-reducing supplements. These are helpful where the stress is from other sources not related to TMS; but where stress results from TMS it is the TMS which should in the first place be tackled.
9)   The major role that CONDITIONING / LEARNING plays should not be forgotten. It plays a huge role in general TMS, so one can expect it to have the same impact in stuttering – where people have been stuttering for decades, the behaviour is probably deeply entrenched. Even so, it might just be that, when the original psychological cause is exposed through TMS treatment, the central nervous system stops feeding the stutter. So I don't think we can expect sudden miracles, because the conditioned responses of many years are still in place. What we can expect is that the intensity of stuttering may begin to drop and hopefully start withering away, because it is no longer being fed.

10) VISUALISATION should be very useful in working on the subconscious. Visualisation is such a powerful tool in modern self-help and it always surprises me how little this is used. At the time when I had TMS-related lower-back pain, I visualised the blood vessels in my back as huge pipes, carrying enormous amounts of blood rushing in waves through the area – to counteract the mild hypoxia (lack of oxygen) which, according to TMS theory, causes painful cramping. In the same way one could visualise oxygen-rich blood rushing toward the vocal-cord muscles, and / or to the speech centres of the brain, so as to prevent a stutter. Have a look at this short chapter on visualisation in my free online book:

As far as I know, this is the first time that TMS principles are applied to stuttering. But will it in fact be of use in real life? Maybe you would like to try it, perhaps adjusting the theory to your own experiences? You would be a true pioneer, charting unsailed waters and perhaps creating history.       
Thanks for reading this article! Below please find some relevant links:

A few sources of practical TMS support:

The TMS Facebook group. (A smart, active and helpful group.) Join them here:

The free online TMS Wiki. (Very comprehensive.) Check it out here:

The free TMS Recovery Program:

The MindBody Workbook: a 30-day program, by Dr David Schechter MD, 1999 (Very helpful, but spelling errors irritate; should have been proofread):

Recommended reading ("knowledge therapy"):

The Great Pain Deception: Faulty Medical Advice Is Making Us Worse, by Steven Ozanich, 2011 (Very dramatic, very comprehensive but rather lengthy; intentionally repeats himself often so that the ideas can sink in deep):

Any of Dr John Sarno's books, such as:

The Divided Mind: the Epidemic of MindBody Disorders, 2007 (Articles by Dr Sarno and like-minded doctors, also covers topics not covered in other TMS books.):

Friday, December 16, 2016

Are you considering speech therapy?

If you as an adult or teen are considering speech therapy, the following tips may assist you:

1.   There can be no doubt that some people find stuttering therapy useful, either in the form of counselling, learning speech techniques, doing exercises provided by the therapist etc. Conversely, others complain that they have not been helped adequately. Often they say that they quickly achieve relative fluency when in the speech clinic, but are unable to maintain this fluency outside of the clinic.

2.   Therapy can be either one-to-one sessions with a therapist or group therapy, often in the form of a workshop or intensive course. While one-to-one sessions can be useful for clients who are hesitant to speak in a group setting, group therapy has the benefit of meeting other people who stutter, so providing opportunities for sharing problems and helpful experiences.

3. Much will depend on your expectations of therapy. Chronic stuttering is difficult to cure 100%. A more realistic expectation would be to aim at improved management of the disorder. Work toward clearly defined, practical goals such as speaking on the telephone, or making presentations before an audience, rather than a vague ideal of better speech.

4. Find a therapist who specialises in stuttering and has the professional qualification to back it up. Speech therapy encompasses many speech disorders, and stuttering is only one of them. These days, the field has broadened to such an extent that, in some countries such as the US, a student therapist can qualify as a speech pathologist / therapist without actually having followed a course in stuttering.

5.   Much will depend on the therapist and her knowledge and skills, as well as her view of stuttering. As in all professions, some professionals are better than others. Some will specialise in one particular approach or technique; others will be flexible in applying a treatment type according to the needs of the client. If you find that you are not making progress with a particular therapist, or a particular type of treatment, you should discuss this with her so that another treatment may be tried; or it may even be necessary to find another therapist.
6.   Try to improve your own knowledge on stuttering, as a preparation for therapy. Join a few Facebook groups for people who stutter; read some of the free online books on stuttering HERE.  Stuttering is to a large extent stress-related, so improve your knowledge of stress and how it can affect stuttering. Eg. the improvement often resulting from therapy within the clinic may be the result of reduced stress levels as you become comfortable with the therapist; outside of the clinic, however, all the usual stressors in your life may still be present, thereby impacting on fluency.

7.   If you are considering following an intensive group course from an organisation treating people who stutter, make sure that it is not a bogus money-making scheme – ask around on the internet. Ascertain if they offer long-term follow-up support and refresher events; don't trust them if they offer a quick cure. Ask if the first day of the course is free or if the fee is returnable should you decide midway that the course is not for you.

8.   Last but not least: Speech therapy seems to work best where there is a shared responsibility between client and therapist. Stuttering therapy is actually for 99% self-therapy; the therapist can only advise and guide, but it's the client who has the problem and who needs to do the real work. In other words: Become your own "therapist"! Wishing you all the best in your journey.

Friday, July 22, 2016

Is stuttering a manifestation of TMS?

Is stuttering a stand-alone speech defect, or part of a broader mindbody disorder known as TMS (tension myositis syndrome, aka The Mindbody Syndrome)?

TMS, which was first put on the map by the pioneering Dr John Sarno, MD, is not an officially recognised medical ailment even though some prominent doctors accept that it exists. Though TMS is usually associated with chronic pain such as lower-back pain, many other disorders such as ulcers, sinus problems, carpal tunnel syndrome, certain headaches / migraines, dry eyes, night muscle cramps, heartburn, eating disorders, "growing pains", chronic fatigue syndrome, various skin disorders, OCD, panic attacks etc. etc. may actually be camouflaged TMS - physical (and sometimes psychological) symptoms having an underlying subconscious base.

Spasmodic dysphonia, another speech disorder involving the vocal cords, may also be TMS-related; but stuttering is seldom thought of as perhaps being a form of TMS, in some cases at least, even though a comparison yields interesting results. Both TMS and stuttering are stress-related; and in both cases, muscle cramps / spasms or muscle “locking / freezing” play a major role (lower-back TMS: tension-related muscle cramps in the lower back causing pain. Stuttering: conditioned struggle reflexes in response to a tension-related “locking” of the vocal-cord muscles).

‘Knowledge therapy’

Dr Sarno regards repressed, unconscious psychological rage – or other repressed emotions such as fear, shame / guilt or sadness – as a major cause of TMS. According to him, TMS acts as a distraction, being a rather rough-and-ready defensive and survival technique from the more primitive parts of the brain; by creating pain or other disturbance through tension-induced hypoxia (lack of oxygen) via the autonomic nervous system (ANS), the conscious mind is distracted away from the inner conflict (which the primitive mind regards as more threatening than the actual external symptom). Other experts believe that TMS is the “inner child's” way of signalling its distress. TMS could therefore also be seen as rough “messages” from the subconscious, from the inner self, that all is not well and that corrective steps are needed.

Perfectionists apparently are highly susceptible to TMS. Perfectionism and "goodism" (the tendency to be as ethical and moral as possible; actually also a form of perfectionism) are particularly enraging to the subconscious "id" (the primitive inner animal / child-like part of the brain).  

Treatment for TMS consists of soothing the inner child, doing certain self-help exercises and, in severe cases, counselling; some people are cured simply by reading a book on TMS, thereby bringing to consciousness the psychological underlay of their physical symptoms, and becoming aware of long-hidden emotions that manifest themselves as ailments.

All this will sound pretty crazy if you share the mindset of modern Western medicine with its strict mind-body division. Don't get me wrong - Western medical science has reached fantastic heights in the past century and should be respected for that; but it suffers from a blind spot when it comes to the grey area between mind and body. Western medicine's epic breakthroughs in the modern age, thanks to its focus on the material body, has seduced it to disregard the more hazy area of mindbody health.

 I must admit that I would not have written this article five years ago. I'm not really into unconventional medicine; but some years ago I had the misfortune of suddenly experiencing excruciating lower-back pain. I won't bore people with the details, but after following the usual conventional route of MRI scans and an epidural injection, without much success, I basically solved my back problem by reading a few TMS books and following their advice. So in my experience, TMS is real. Since then I suspect that some of my other, mainly stomach-related, previous ailments were actually TMS-related. I'm even wondering whether my lifelong stuttering, though mild these days, is part of TMS and whether TMS treatment will have an effect on it. 

A vicious circle

TMS is, of course, radically different from current mainstream views on stuttering. Current mainstream thinking regards developmental stuttering as a neurological disorder, with the cause or causes not being psychological in nature. I have no doubt that stuttering has a genetic and neurological component, and that some kids are predisposed to begin to stutter. But does this exclude the possibility of unconscious psychological factors in the period when children begin to talk?

Let's consider the onset of stuttering, usually between the age of 3 and 5. For some predisposed kids, overt stress seems to be the trigger; for instance, some children begin to stutter after a traumatic incident such as a car accident, or after having been bitten by a dog, or after a parental divorce. Here the stress trigger seems clear.

In most cases, however, the stress is not so obvious. It could be argued that the actual learning of language also involves stress triggers: the child needs to master complex grammar, new meanings and difficult pronunciations, all of which could overstress a still immature speech system.    

But perhaps a psychological stress trigger is also possible? Consider, for instance, the following scenario: a child, perhaps rather sensitive by nature, wants to please his parents (as most kids want), but soon learns that anger (fighting / resisting), a normal response to ordinary day-to-day irritations and part of the fight / flight / freeze reaction, is frowned upon. He quickly adapts to this by repressing his "fight" response and instead initiates the "freeze" response (if "flight" is not an option); in other words, he does nothing and keeps quiet (perhaps starting on the road to a degree of introversion - but that's another story which I won't go into here). Repressing the fight response, however, merely relegates his anger to his subconscious, so that unconscious rage begins to build up. The same may happen with other emotions that the child may regard as socially inappropriate, such as sadness, fear and anxiety. And built-up unconscious emotions, so Dr Sarno has taught us, can generate tension and seek a physical outlet.

In this particular, genetically predisposed individual the outlet is the vocal cords that “lock” or “freeze”  - as per the pioneering work of Dr Martin Schwartz, who was instrumental in identifying the role of the vocal cords that freeze when overstressed. Apparently some people are genetically and neurologically predisposed to direct their tension to their vocal cords, just as others direct their tension to other body parts. And so the stress response of freezing becomes a physical “freeze” of the vocal-cord muscles; and the child begins to stutter - the actual sound or word repetitions are simply conditioned reflexes in response to the vocal-cord freeze. The stuttering, in turn, will increase the unconscious inner rage and stress, so that a vicious circle is created, established and strengthened over the years.

The TMS argument can be taken even further. TMS experts would argue that mindbody issues are often symbolic; that the mindbody often chooses a particular body part to symbolically communicate its message. In his book The Great Pain Deception, Steven Ozanich says, in discussing spasmodic dysphonia, that the vocal cords are common targets of tension since the voice is a mechanism of expressing self. In the same way, TMS-related shoulder pain may indicate that the subconscious mind feels that it is "carrying the world on its shoulders". 

A major question would be the following: if stuttering is a type of TMS, is that TMS still active in adulthood; or did the TMS only occur in early childhood, so resulting in stuttering and creating the conditioned responses, after which the TMS itself receded so that the conditioned stuttering remained as a leftover, continuing into adulthood? In the case of this last-mentioned scenario, TMS treatment will obviously not have any effect.

Major implications for treatment

If the stuttering of some people is indeed a type of TMS, it has major implications for treatment. For instance, if unconscious rage is identified as a driver of stuttering in an individual, he could perhaps be helped by focusing on assertiveness. Assertiveness could be seen as a “civilized”, subdued and socially acceptable form of anger, thereby tapping into, channeling and discharging the unconscious rage. (For a short summary of assertiveness as a tool in improving fluency, check out THIS CHAPTER of my free online book, Coping with Stuttering. And for an excellent TED talk on how a few assertive body positions will actually change your body chemistry to make you more relaxed and assertive, click here.)

A major part of TMS treatment is to convince the client's conscious as well as subconscious mind that the problem is fundamentally psychological and NOT structural (after, of course, having excluded the possibility that there is indeed a serious structural defect or injury). This convincing is necessary so that the subconscious mind - the level at which the problem arises - will stop trying to distract you by means of the symptoms. If the subconscious mind becomes aware that its distraction tricks no longer work, it stops its mischief.  I know, it sounds unbelievable - but it works. The proof of the pudding lies in the eating. So many people are benefiting from TMS treatment that it needs to be taken seriously.

Applied to stuttering, it would mean that you have to be convinced, and have to convince your subconscious, that unconscious emotions drive your stuttering. 

A complicating factor, of course, is that stuttering is usually developmental, with onset before school-going age, which means that the years or decades of stuttering and its conditioned components - the force of habit - will need to be taken into account. In TMS, conditioning and learning play a major role, and one can expect that the power of conditioning will be a formidable obstacle for those who want to tackle their stuttering through TMS treatment. However, the TMS treatment may stop the stutter from being fed by the subconscious source, ultimately leading to it withering away.  

Finding your own way

All this is of course speculation; even if it has merit it may be extremely difficult to convince both speech experts and people who stutter, as there is a lot of resistance to the seemingly very alternative and way-out TMS concept ... most people prefer to listen to conventional, officially accepted medical advice. Also, many people hate the idea of having to deal with "mental" issues that still carry the stigma of perhaps being "crazy", and may be unwilling to face their inner demons, preferring physical treatments that are socially acceptable and easier to handle.

Most speech professionals, again, will say that the psychological approach to stuttering has long since been discarded, and that the focus these days is on neurology and brain scanning. They will be quick to tell you that Freud, the father of modern psychology and of psychoanalysis, did not succeed in treating people who stuttered (even though we have come a long way since Freud, with our knowledge of psychology and stress having expanded enormously since then).

So once again it is up to the individual with an open mind to try and find his own way, and experiment with this, or any other, approach which makes sense. Fortunately a small but growing number of doctors are embracing the TMS concept and treating patients accordingly.   

If you're interested in TMS, check out the TMS Wiki site HERE where you will also find a growing list of disorders that may actually be types of TMS. For an excellent introduction to TMS, read Dr John Sarno's Healing Back Pain: The Mind-Body Connection . And for a very comprehensive book on TMS in its many manifestations, have a look at Steven Ozanich's The Great Pain Deception: Faulty Medical Advice Is Making Us Worse. It may radically change the way you view health. And isn't stuttering a part of health? Or else read any of the other books by Dr Sarno, for instance The Divided Mind: The Epidemic Of Mindbody Disorders.  Also consider joining the Facebook group on TMS.

For those who stutter and wish to experiment with this approach, I would suggest that you (1) work on adopting an assertive manner just before speaking, as mentioned above; and (2) carefully read one or more of the TMS books, such as The Great Pain Deception mentioned above, substituting the word "pain" with "stuttering". In other words, read the books as if it were all about stuttering instead of chronic pain. If the stuttering of some people is indeed a type of TMS, the chronic laryngeal blocks may just be the subconscious mind's way of distracting you away from unconscious emotions. Try to re-read these books as often as possible so that the concepts sink in deep into your subconscious, where the real healing occurs; (3) keep a daily journal of your experiences with and feelings about your speech - journalling is a highly successful tool used by TMS sufferers (4) follow a TMS treatment course, again doing the exercises as if it were about stuttering. A free online course can be found at the TMS Wiki ; or do the exercises in the book Unlearn Your Pain, by Dr Howard Schubiner , a medical doctor and TMS practitioner; or any other TMS workbook; (5) join the Facebook group "Stuttering as a mindbody disorder" HERE:  

Feel free to provide feedback in the comments section below if you are experimenting or have experimented with TMS treatment for stuttering. PS Don't be upset when things get worse before they get better! This is typical in TMS treatment, as the subconscious tries to maintain the status quo when it notes that things are changing. TMS treatment is a journey; so be sure to join the TMS Facebook support group mentioned above.

Update January 2017: According to new research, there are indications of reduced blood flow to the brain's speech centres during stuttering. This could strengthen the argument that stuttering is a type of TMS. Keep in mind that, according to the TMS experts, TMS symptoms are physiologically effected by a reduced oxygen supply to the affected area. It could be that the central nervous system reduces the blood flow to the speech centres, thereby reducing the oxygen supply to those areas, so messing up these centres and resulting in the dyscoordination of the vocal cords and the resultant vocal-cord freezing that in turn results in stuttering. Check out this research article. 

Monday, October 12, 2015

'Tightening' of vocal cords results in stuttering, says AIS

Emily Blunt, the beautiful UK actress who is also a board member of the American Institute for Stuttering (AIS). The AIS has come out in support of the concept that stuttering results from a tightening or closure of the vocal cords.

Good news for people who stutter is that the American Institute for Stuttering (AIS), a leading organisation in New York offering treatment for this disorder, has joined those who believe that stuttering results from a tightening of the vocal cords.

The role of the vocal cords in stuttering has for decades been a hotly debated issue among speech experts. Though speech therapists generally accept that the vocal cords can behave unnaturally during stuttering, the traditional view has been that word and sound repetitions, prolongations and unnatural vocal-cord behaviour are all primary manifestations of this mysterious disorder.

In contrast there has been, for many decades, a dissenting line of experts who insist that an unnatural tightening, "locking" or "freezing" of the vocal cords, apparently caused by excessive tension on the cords, triggers the speech repetitions and other struggle behaviours. In other words, the internal vocal-cord spasm happens first and leads to the other, more visible symptoms. 

Fundamental implications

"It appears as if there is a timing problem in the communication of signals from the brain to the speech mechanism. This 'glitch' results in a tightening or closure of the vocal cords. Because of this tightening in the throat, breathing and mouth movements become forced and laboured," according to the AIS's current website.

The view that vocal-cord spasms result in stuttering has fundamental implications for stuttering treatment, as it implies that the focus of treatment should be on the vocal cords, instead of attempting to deal with the stuttering itself. If the vocal cords can be made to behave, the stutter is aborted as it depends on the cord spasm occurring. 

This blog has consistently argued for years that stuttering is a conditioned reflex, resulting from a tension-related "locking" of the vocal cords. Traditional treatment aimed at the stuttering itself is misplaced as it does not address the true problem, namely the erratic, abnormal behaviour of over-tensed vocal cords. The vocal-cord muscles seem to behave this way because, when overstressed, the fine vocal-cord muscle coordination necessary for normal speech breaks down.

Reflexive attempt

A vocal-cord tightening (or "block" as it is called by people who stutter) can easily be reproduced artificially, according to the AIS website. "Take in a breath of air, keeping your mouth open, and hold your breath. Then let little puffs of air out. Feel the sensation in your throat. You just closed your vocal cords on purpose. If you stutter, this feeling will be all too familiar. Now, do that again. Hold your breath with your mouth open, don't let any air out at all and try to speak.

"If you don't stutter you have just created the physical sensation of what we call blocking. You know what you want to say, but imagine trying to speak and nothing comes out. Those who stutter, experience this all the time. It's as if they are choking when trying to speak.

"In a reflexive attempt to help the person speak, the mouth muscles (articulators) then kick into 'overdrive' to compensate for the vocal cords that aren't 'working'. This is the aspect of stuttering that most people see."

The AIS's view of stuttering shows that this approach to stuttering is gaining ground within therapy circles. Hopefully other speech professionals will follow their example. This is a major step toward improved and more realistic stuttering therapy.