The book contains the latest information on the thiamin (vitamin B1) and magnesium treatment protocol for people who stutter. According to Dr Schwartz's original trial study, of which you can read more HERE, about 1/3 of adult males who stutter can be helped significantly by following the protocol.
If you have previously tried these supplements without any effect, do read this book as you may have omitted or done something which compromised your fluency. For instance, some foods and drinks, as well as some medicines, contain anti-B1 factors such as caffeine, sugars and sweetened beverages. It makes no sense to take B1 pills if, at the same time, your diet neutralises the B1 in your body. So it's important to follow a pro-B1 diet during the 3-week test period.
This book is not only valuable because of the thiamin treatment, but also as it clearly sets out Dr Schwartz's view of how and why people stutter. Chapter 5, titled "The trigger for stuttering", explains how a stress-related dyscoordination of the vocal cords within the larynx results in vocal-cord "locking". The speech repetitions and prolongations which we hear as "stuttering" are merely learned struggle behaviours in an effort to speak in spite of the vocal cords that intermittently lock to a greater or lesser extent.
This dyscoordination, in turn, could be due to a deficiency of the GABA neurotransmitter in the brain. Vitamin B1 is required for the proper functioning of GABA, so this may be why thiamin improves fluency in some people.
The thinking man or woman's speech therapist
Finally, for those who do not benefit from the thiamin protocol, the author gives an overview of his "Intent Therapy". Intent Therapy resembles the "slow onset" approach, but also requires a "mental comma" after the first word (if a monosyllabic word), with the rest of the sentence spoken as an afterthought. Intent Therapy is actually part of his Passive Airflow Technique, but is presented here as a simplified stand-alone approach.
"The important thing is not to have the rest of the sentence in your mind before you say the first word," he writes. You must intend to say just one word, and then shift your intent and say the rest of the sentence. The purpose is to reduce pre-speech tension on the vocal cords, which would otherwise result in stuttering. This technique, if done correctly, sounds quite natural but, as with all fluency techniques, needs to be practised a lot.
Dr Schwartz's books have consistently re-defined stuttering and its treatment, beginning with the highly controversial Stuttering Solved (1976) up to Stutter No More (1991), and The Thiamin Protocol is no exception. He is the thinking man or woman's speech therapist and so is not everybody's cup of tea, but I love his work.
Do read this latest book, try the protocol if you haven't yet done so, and study Chapter 5 for a very plausible explanation of stuttering. And for a fuller picture of the author's thinking about stuttering also read Stutter No More, a 65-page free PDF - focused on his Airflow approach - which can be downloaded HERE. Dr Schwartz is to be commended for making these important books available for free to the stuttering community. Hopefully other authors will follow his example.
I there any research going on with two third of stutterers who are not benefited from thiamine protocol....like enhancing thiamine absorption or cross blood brain barrier
ReplyDeleteAnonymous, I am not aware of any such formal research. There is not much interest in this line of thinking unfortunately. So don't hold your breath ... personally I believe that it is up to us to experiment with various approaches. It may be that thiamine acts as a relaxant; the B vitamins are generally said to be good for the nerves. I'm taking it and it does seem to take the edge off stress levels, so indirectly it may help with fluency. But there are a lot of other factors involved here. It may be that the higher the dose, the greater the relaxation, though too much could be harmful in other ways. Also much depends on one's diet; some foods and drinks reduce thiamine in the body, and so do various medicines. But I also believe that other factors impact on fluency, such as stress levels, the force of habit (conditioning / learning) and psychological drivers of tension.
ReplyDeleteAfter reading Thiamine protocol , we will feel that the mysteries of stuttering has been found that but yet a cure is not found. If the cause for stuttering is known (spasm at Vocal chords) then what is the delay in finding a cure. In this developed world we have significant improvement and development in all notable diseases, but there is not much interest in stuttering. We cant accept there is no cure for stuttering in this world.
ReplyDeleteA cure may be difficult, because stuttering seems to be partly behaviour - it's something you DO, it's not something that happens to you like an illness. Stuttering happens because of the vocal cords that lock down, and these locks have become habitual (conditioned / learned). Unlearning that is difficult because the learning happened when we were still very young, so it's deeply ingrained and established. Then also, it is "fed" by tension and stress - and stress is something that is around us and within us all the time.
DeleteA decided to try the thiamine protocol, and I'm a little confused about the diet that we have to follow during the three week period. The PDF says to follow an alkaline-forming diet, and I read that means no meat, dairy, simple carbs, or most grains. That's a pretty restrictive diet but I would definitely be willing to follow it during the three week period. I'm on my fourth day of the test, so I'm following the diet but not taking the supplements yet, and I've been eating mostly vegetables, fruits, almonds, potatoes, tofu, and quinoa. What I'm confused about is in the PDF it also says that spinach, soybeans, and nuts contain phytic and oxalic acids which cause magnesium to be eliminated from the body, so wouldn't that prevent the absorbtion of the supplements? I can't really avoid those foods because they're staples of the alkaline diet, so I wouldn't have much left to eat if I didn't eat them. Also, do I need to follow the alkaline diet 100%, or do I just need to eat a certain percent of alkalizing foods? Can you please explain what the ideal foods would be to eat during the test period?
ReplyDeleteThank you
Dear Unknown, thank you for your sensible questions. Firstly, I'm not a nutritionist - the thiamin protocol was devised by Dr Martin Schwartz who is a speech expert - but even so I'm going to try to answer. Regarding soy beans: soy beans are acid-promoting so should anyway be avoided for our purposes. Spinach, according to my information, should be cooked, otherwise it will indeed reduce magnesium uptake. Nuts do contain phytic acid which reduces magnesium, but according to some health experts a moderate amount of nuts is healthy as phytic acid also has some health benefits so should not be eliminated totally. In fact you will anyway ingest some phytic acid as it is part of many types of food. I definitely think that you should not follow the alkaline diet 100% as that would not be practical anyway. The main thing is to eliminate coffee, tea, sugar, raw seafood, alcohol and antacids as these are major anti-B1 factors; and then to take the recommended dosages of B1 HCL and magnesium glycinate. The ideal food during the test period: I think that's up to you, but the more alkaline-promoting foods / drinks you choose, the better. But as said, the main thing is to focus on not taking coffee etc. PS: Note that some people are saying that the recommended daily dosage of B1 HCL, namely 300 mg, is insufficient and that a higher dosage gives better results speech-wise. That may be so, but such higher dosages may also increase other unknown health risks. Anyway before going on the protocol one needs to get the green light from one's doctor. I hope that this info is helpful. Good luck with the protocol and I hope that it will help you! Keep in mind that self-suggestion and the placebo effect play a major part, distorting any real effect. Many people are tricked by this, experiencing sudden fluency after going on the protocol, only to be disappointed after a few days when a relapse occurs. Only if real improvement continues for at least 3 weeks can one begin to think that the protocol is working for you. Even then, psychological relapses may occur - as long-term stuttering is not easily cured. Having said that, there is something to the protocol. I've been on it for many months and find a definite improvement even though for me it's not a cure. The B1-magnesium probably soothes the nervous system, or may have some other biochemical benefit as hypothesised by Dr Schwartz. So I still use the protocol, but also other methods such as the Passive Airflow Technique. Kind regards.
DeleteThanks for the reply. There seems to be some variation in different websites and charts for which foods are acid-forming or alkaline-forming, because many of the websites I looked at listed soy as alkaline forming. You said I don't have to follow it 100% percent, so I guess it doesn't really matter too much, I'll just generally follow the common theme of more fruits and vegetables and less meats and simple carbs, as well as avoiding the specific foods you mentioned and cooking spinach before eating it. I'll let you know how it works. Alex
ReplyDeleteUnfortunately I didn't get any improvement at all from the thiamine protocol. I guess I'm just not one of the lucky 38%. I still want to speak fluently though, so I decided I'm going to move on to intent therapy. I think I pretty much know what I need to do from the PDF, but I understand that if I don't use perfect technique it will still be possible to stutter. So I'm just wondering if you know of anyone who can be a monitor for me, and identify any mistakes I might be making that are causing me to still have difficulty if I encounter any. I understand Dr Schwartz is retired now and doesn't put on workshops anymore, but do you know if he still helps people personally by giving feedback on speech recordings or anything like that? About a year ago I emailed Andrew Greenstein since I heard he was a successful user of intent therapy and was coaching other people, but I never got a response.
ReplyDeleteThank you, Alex
Dear Alex, I am sorry that the thiamine protocol didn't do anything for you. Regarding your search for a monitor: I would suggest that you join the Stuttering Therapy Alternatives (STA) group on Facebook, or else The Passive Airflow Approach To Stuttering group, also on Facebook, though the latter is smaller than the former. In the STA group you will hopefully find someone who can help. Note that intent therapy (closely related to the Passive Airflow Technique) is only a control and management technique and not a cure, and that a lot of regular practising is required for optimal benefit. I'm afraid that both Dr Schwartz and Andrew Greenstein won't be able to assist - Dr Schwartz is in his seventies and Andrew Greenstein does indeed not respond, I've also tried to contact him without success. Regarding Intent Therapy: it's a later version of the Passive Airflow Technique (PAT), but without the airflow itself and just containing the "intent to rest" part and the "slowed first syllable" as Dr Schwartz later decided that the airflow part was too difficult for most. You will find lots of background information on the PAT / Intent Therapy on this blog as well as on its associated blog containing my free online book titled Coping With Stuttering, which is all about the PAT approach. Both the book and this blog contain a mass of PAT information, including my own videos as well as Dr Schwartz's training videos, on the airflow / intent approach. To this I would add that group support, in the form of attending self-help / support groups, could be of immense help in testing and practising these techniques which are all about vocal-cord control combined with stress management. Apart from attending support groups, it would also greatly help to join various Facebook online stuttering support groups. I have already mentioned two, but there are also other, more general groups such as Stuttering Community, Stuttering Arena and Stuttering Hangout. Best of luck and I hope that this info will be of assistance. Personally I believe that a combination of fluency techniques, stress management and psychological approaches work best to deal with stuttering. Here is a link to the STA group: https://www.facebook.com/groups/stuttheralt/
DeleteThanks for the reply. About the thiamine protocol, I'm just wondering if you know of any follow up studies that were done to verify Dr. Schwartz's findings? I heard that a few years ago he was submitting the study to the New England Journal of Medicine, and getting some other researchers to try to replicate his results. I tried searching the internet for follow up studies, but surprisingly I couldn't find any. You would think that virtually eliminating stuttering in a third of all people who stutter with a nutritional supplement would be pretty significant, and there would be tons of follow up studies and articles all over the internet when you even just type in the word stuttering. So I must say I was absolutely shocked to not find any.
ReplyDeleteI'm not aware of any such follow-up studies. As far as I know, he hasn't published his study in any journals; he did try, but because he had already published it on the internet, the relevant journal refused publication. There are some other factors involved here. Firstly, I think that some experts feel that this issue has been covered in the past - with the Hale study of the 1950s and the responses thereto. The Hale study, in which the thiamine effect was mentioned, was criticized for various reasons, so I think that many experts regard the issue as settled. Then also, Dr Schwartz has had running battles with the US speech therapy establishment for decades (i.a. because of his conviction that stuttering is preceded by a vocal-cord freeze), so many so-called "experts" would tend to dismiss any claims of his because of prejudice. Thirdly, long-term results from the thiamine protocol are still absent; much of the good anecdotal results one hears about may be due to self-suggestion and the placebo effect. Fourthly, I think there's a lot of cynicism and pessimism regarding successful stuttering treatment; many people just don't believe that anything as simple as a vitamin can improve fluency in some people. Finally, I am not sure if the thiamin protocol really "eliminates" stuttering in a third of all people who stutter. Actual results may differ; as said, there are no long-term and officially monitored results, say after 5 or 10 years of continued usage of thiamin. I think the thiamin studies should be further refined, also taking into account various medicines and foods that deplete thiamin in the bodies of trial participants. Regrettably, expert interest in this line of thinking seems to be non-existent. It's a huge opportunity for young, ambitious speech professionals to make a contribution by continuing where Dr Schwartz left off!
ReplyDeleteI'm surprised some experts don't believe its caused by a vocal-cord freeze, that's actually exactly what it feels like happens to me. When I get stuck I always know what I want to say, and I can mouth the words silently, but there just wouldn't be any sound, so I have to just silently wait until the vocal cords get unstuck before I can start or continue talking. Dr. Schwartz's theory just makes so much sense. It's obviously the vocal cords locking or not vibrating that's the problem, and its obviously caused by stress since pretty much nobody stutters in a room by themselves. So anyways, I've been practicing intent therapy for a week now, and I got my parents to monitor me (I'm seventeen). I never stutter when I'm practicing, and in the easy situations I often speak with near perfect fluency now. Before starting this I would usually have a short block on every two or three words even in the easy situations. I've actually tried it in more difficult situations too with some success, but what often happens is my vocal cords lock up right before I say the first word, even though I intend to say it by itself, and slowly, and softly. Then I'm not sure what to do, so I just revert back to struggle behaviour and push it out, and then the rest of the sentence goes just as badly. That seems to happen mostly on the first sentence that I say to someone, and then the rest of the sentences sometimes go ok. I was planning on not using the airflow technique since its hard to master, but do you think that would be the only way to get that first word out quickly in stressful situations? I would really like to get that first word out quickly since its pretty hard to actually join or start a conversation if it takes too long.
ReplyDeleteThank you,
Alex
Hi Alex - I'm actually not an expert on Intent Therapy, because I was trained, and also trained myself, on the Passive Airflow Technique. Personally I disagree somewhat with Dr Schwartz, as I believe that the airflow is easier than Intent Therapy, or at least it was / is for me. One point to remember is that, whatever approach you use, you definitely need to SLOW the first syllable, or first TWO SYLLABLES if a multisyllabic word. That will significantly reduce vocal-cord tension at the beginning of the utterance. You CAN'T afford to get that first word out quickly - you will have to practise interrupting people while still using slowed first syllable - that's what is called the Toughening Exercise. Also remember to RELAX MENTALLY AS WELL AS PHYSICALLY while using your technique. And yes, if Intent Therapy doesn't work well for you, you should maybe try adding the "passive airflow" aspect. And again, relax mentally and physically while airflowing, slightly relaxing all your muscles while flowing out. Also, the transition from flowing out to actually speaking must be very smooth and natural, (no break between "flowing" and "speaking") otherwise the cords will get an opportunity to lock down again. Personally I found the "intent" aspect too difficult, though it does help when I can remember to use it. I find airflowing much easier; after so much practising I find it easy to emit these slight outward sighs before speaking, and they do help especially when I also slow down that first word. It's great that you got your parents to monitor you! The high-stress situations can be difficult. That's where the gradual desensitization steps come in, where you begin with low-stress situations until you feel 100% confident in those situations before climbing the ladder toward more difficult situations. Don't try the more difficult situations if you're not quite comfortable with the lower ones ... don't be over-hasty! This is going to take time; you have to allow your subconscious mind to adjust to more fluency. If fluency comes too quickly, your subconscious may "rebel" and cause a relapse, so take it slowly and gently ... Again I would strongly recommend that you join the Stuttering Therapy Alternatives Facebook group, because I know someone there who is also practising the Intent Therapy, I think with a small group via mobile phone and Whatsup - they send each other recordings I believe. Such a support group should help you a great deal. Actually this blog is not the best medium for giving advice, as the audience is very limited. I hope to see you on Facebook! Kind regards.
DeleteWell its been about 5 months now that I've been taking vitamin b1, b complex in raisin juice, magnesium, vitamin c, Calms Forte, and coral calcium, as well as intent intent therapy and all of the other Schwartz exercises like bathtub technique, education and demonstration, toughening, etc, and I must say I'm nearly 100% fluent now in most situations. There's only the occasional speaking situation now that I'll stutter in. And I used to stutter severely in every speaking situation. This stuff really works, no doubt about it. I'm being mentored by Andrew Greenstein, and I think being walked through this program one on one with somebody who's done it before really makes it a lot easier.
DeleteGreat to hear that! It seems that you are really working hard on your speech, and reaping the rewards! With Passive Airflow I too have found that putting in the work does bring results. Most people who try it are not really sufficiently motivated to put in the daily work required. The Bathtub Exercise I found extremely helpful, it relaxed me for the whole day when I did it in the morning before going to work. I'm glad to hear that you managed to contact Andrew Greenstein! You're right, it's best to do all this together with someone - whether a therapist / speech pathologist or friend, etc. Personally I'm working on something new these days. You may have seen my latest posts in which I explore a more psychological approach to stuttering which I find very helpful. I believe that the passive airflow / intent therapy addresses the physical part of stuttering, but not the psychological part, and that's what I'm focusing on now. I actually believe that stuttering is part of a broader "mindbody" disorder called TMS (tension myositis syndrome) caused by repressed emotions. But, that's another conversation! Great news that your fluency has improved so much, and I hope that you will continue on this journey! All the best.
DeleteHave you heard of John Harrison? He believes people who stutter lock their vocal cords to prevent themselves from speaking because they subconsciously want to hold back their emotions. I think Andrew also used a few different psychological approaches like hypnotherapy and EFT to bring repressed emotions to the surface after he became mostly fluent with the slow start technique.
ReplyDeleteHow long would you say it took you to have your speech mostly under control in all situations after you started using the passive airflow/slow start technique?`
Interesting view of John Harrison's work! I only know about his Hexagon concept, which seems to me to reflect the various stresses to which we are subject. He has written so many books that it's hard to know all his views.
DeleteThe airflow approach has its limits for me and it does not solve all situations. It's a great technique for general use and I use it daily when I feel I need it, but it's difficult to use in high stress situations. I worked on it since the 1980s, so that's about 37 years, but it took about two years for me to get the basics right. The amount of work it took and the long duration are major drawbacks of this approach. That's why I'm now experimenting with TMS treatment, which I find extremely helpful as it seems to address the core cause, namely repressed emotions.
If you're on Facebook, feel free to join my new group, "Stuttering as a mindbody disorder" which you may find very interesting and helpful. Already two other guys are finding TMS treatment very helpful, even dramatically so. There's also my other group, "The Passive Airflow Approach to Stuttering". I find Facebook much more effective than blogging, as communication is quicker and more direct. Hoping to see you in "Stuttering as a mindbody disorder"! All the best with your current journey. Here is the address of my new group: https://www.facebook.com/groups/1808396596092330/?ref=bookmarks