Thursday, August 31, 2017

My mindbody treatment principles for stuttering





Below please find my mindbody treatment principles for stuttering that seem to help people in the "Stuttering as a mindbody disorder" Facebook group:


A healing programme to deal with TMS stuttering - Version 1.5   August 2017 - (For the latest version of this document, visit the Facebook group "Stuttering as a mindbody disorder" )                                                                           © Peter Louw

  
Introduction

For general TMS pain, various healing programmes have already been developed – some are contained in books, such as Zero Pain Now, by Adam Heller, or Unlearn Your Pain, by Dr Howard Schubiner MD, and some are found for free on the internet, such as the TMS Wiki Recovery Program. These programmes are, of course, aimed at TMS pain rather than stuttering, so naturally if you wish to follow these programmes you should, in your mind, replace the word "pain" with "stutter" wherever you find it. Even so it seems logical to also develop a dedicated TMS programme for people who stutter (PWS), so here goes – and I will try to make this as short as possible.

Mindbody healing for stuttering is aimed at changing our mindset about stuttering. We have to start thinking differently about stuttering, on a conscious as well as subconscious level. This we do by receiving new information about stuttering. Ultimately the information received consciously should sink in to reach the subconscious, where true healing occurs.

But … a mindbody (aka psycho-physical) disorder has a mental as well as physical side. The mind may cause the symptoms, but the symptoms are real and physical.  Feedback I've received indicates that the mindbody approach to stuttering works best when combined with a good fluency technique – such as the Passive Airflow Technique (PAT) – to deal with the physical side of stuttering. So if you're not making progress with mindbody tools only, try combining them with the PAT or other fluency technique. In section "E" below you will find more details on PAT.

A.   Preparatory phase ("knowledge therapy")

Get basic information about TMS (tension myositis syndrome) and understand why and how it causes stuttering. For a quick summary, read the basic info document in the Files menu of this Facebook group. Note that you need to have an open mind about stuttering, because at first sight the theory may seem far-fetched!

The TMS explanation needs to sink in deeply so that it reaches the subconscious. YOU need to be convinced that the TMS explanation makes sense and that many people have been helped by it. Without this belief, the subconscious will continue to send symptoms. Much of the healing happens on a subconscious level; and how will the subconscious be convinced if you CONSCIOUSLY are not convinced?

Videos: Check out a few of the many Youtube videos by or featuring Dr John Sarno MD, Dr Howard Schubiner MD, Dr David Schechter MD or any other TMS practitioner.

Books: Try to read at least TWO books on TMS, so that these ideas can begin to sink in. Check out THIS LIST OF TMS BOOKS.

Note that TMS is an open-ended concept – many disorders not specifically mentioned in these books may also be generated psychologically, just like TMS pain. So read these books as if they are all about stuttering, not just pain.

Many people say that Dr John Sarno's bestseller, Healing Back Pain: The Mind-Body Connection, is their favourite; but it is not strong on practical exercises. A nice one which is an easy read, yet contains useful exercises but is not on the above list: Zero Pain Now, by Adam Heller.

But don't get stuck in this reading phase forever – at some stage you will have to start applying your newly acquired knowledge to your actual symptoms. If the books have convinced you that TMS is indeed causing your stutter, it may be time to start doing the work. And that means beginning to apply mindbody principles in real life to stuttering. Here are a few:

B.   Principles to focus on

"Do not focus on the physical – focus on the psychological." 

TRY TO IGNORE THE ACTUAL STUTTER AS MUCH AS POSSIBLE. Stuttering is only a SYMPTOM; the CAUSE is mostly repressed negative emotions such as anger / rage, fear, sadness or else daily stress/tension (in any of its many forms). The more you focus on the actual stutter, the longer it will take to overcome it. The reason for this is that stuttering is a psychological defense mechanism, and its purpose is to distract your conscious mind away from repressed negative emotion(s) and / or thoughts that threaten to rise to the conscious surface. If you obsess over stuttering, the subconscious receives the message that its defence is successful, so that there is no reason to remove it. But when you ignore the stutter, the subconscious gets the message that the stutter is ineffective. This seems to "discourage" the subconscious defense system from sending symptoms. Believe me, this strategy works! I know, it sounds weird … but then the human mind is a strange and mysterious thing.

So do avoid over-thinking or talking about stuttering itself, or its mechanics; rather analyse the feelings behind the stutter. It is such a pity that so many stuttering groups / organisations obsessively focus on the symptoms, thereby actually aggravating the problem.


"Continuously identify, acknowledge and accept the subconscious, repressed negative emotion(s) that cause symptoms".

It is not always easy to pinpoint these emotions, but very often they are bottled-up and unaware RAGE / ANGER. FEAR, sadness, loneliness, shame / embarrassment, guilt and regret are some other feelings often behind the stutter. Some feelings, such as irritation and frustration, simpy "hide" behind the "real" feeling which is anger / rage. Often these emotions have been carried over subconsciously from childhood. In the "Files" menu of this Facebook group you will find a list of emotions that usually play a role in TMS.

Sometimes, however, the stutter is caused or made worse simply by day-to-day stresses due to work, kids, relationships, family, health, bad news etc. Keep in mind the bottom line, which is the fact that mind and body are interrelated, and that the one affects the other.


"Perfectionism enrages the inner child".

Stuttering can be seen from two angles: (1) As a defensive mechanism, with the purpose of distracting us from repressed, unacceptable emotions (2) As the "voice" of the "inner child". What is the inner child, you may ask. Well, the inner child can be seen as that part of the subconscious which stores our experiences, attitudes and feelings of the time when we were young.

This inner child is not unlike a real child, but it's more than a child. It's also our animal nature, our primitive side (in Freudian psychology it's called the "id"). It seeks pleasure; it is dependent and intellectually lazy; it is extremely selfish, emotionally immature and quick to anger. And it HATES two things: perfectionism, and goodism (the tendency to be extremely "good", unselfish and self-sacrificing. Actually, goodism is a form of perfectionism). Very often, mindbody symptoms are caused by the inner child who is enraged because of the perfectionist and goodist demands made on it by our mature self. Perfectionism and goodism may feed a huge pool of repressed rage, thereby creating psychological tension which maintains mindbody symptoms such as stuttering. So do avoid perfectionism and goodism!  
  

"Develop an attitude of disdain toward the stutter" 

"I encourage patients to develop an attitude of disdain toward the (stutter) to replace their strong feelings of intimidation. This sends a message to the subconscious that the strategy of keeping attention focused on the body is about to fail - which means the cessation of (stuttering)." --- Dr John Sarno MD, in his book Healing Back Pain - The Mind-Body Connection. (Quotation slightly changed to make it relevant to stuttering.)

Note, however, that some of the TMS people disagree with Dr. Sarno on this point. They say that symptoms (pain, stuttering etc.) are the "cries" or "weeping" of the inner child, and that this child should not be treated with disdain, but rather comforted and loved. So do experiment with both of these approaches to see which works best for you.


"Journalling":

 Many people find it helpful to WRITE about their stuttering; the problems it caused in the past as well as the present; what makes your fluency worse or better etc. Try to focus on the social / psychological reasons for the stutter, not the physical stuttering itself – because, remember, stuttering is just a symptom. You can write in a diary, on a blog etc. Consider actually writing a book; this could go a long way toward fluency as the psychological benefits of discharging, expressing and sharing of emotions could be immense.

This is not recommended for everybody, as journalling makes some people re-live traumatic or otherwise upsetting experiences.


"Do not repress – express!" 

Expressing yourself is the opposite of repressing emotions. Use body language (gestures, facial expressions etc.) and emotions to support your communication. Speak louder, vary your pitch. Don't sound like a robot! Watch how movie or TV actors express themselves in the roles they play, and learn from them. 

Various well-known movie stars who used to stutter have found that acting makes them fluent – because acting is highly creative and expresses their deepest feelings. If you are by nature introverted / inhibited, try to develop your extroverted side. And keep in mind that shyness is NOT an inherited trait; shyness is learned and can be unlearned. In the words of John Harrison, the well-known American self-help expert on stuttering who conquered his stutter: "Do not hold back!"

MUSIC can be a great help in getting in touch with and expressing emotions. Learning to play a musical instrument would obviously be highly useful; but even just LISTENING to music may stimulate your emotional side.


"Talk often to your subconscious." 

Tell your subconscious that you are "on to it" and its deception, that you refuse to be controlled by it and that you will no longer be intimidated by the stutter. This sends a powerful message to the subconscious that the tide has turned and that you are in control.

Also, "talk" to your inner child daily. Children tend to feel vulnerable, dependent and weak. Such feelings are often repressed and subconsciously carried into adulthood, resulting in physical symptoms. Tell your inner child that you are no longer the weak, vulnerable child you may have been decades ago and that therefore there is no more reason for anxiety. As an adult you know so much more – you are streetwise and much stronger. This message has to sink in deeply into the subconscious. 


"Be assertive."

"Keep your anger close to you, like a dog on a leash." This could be useful if repressed rage / anger is causing your problems. It really means having an assertive yet non-confrontational speaking style. Assertiveness, being a civilised, mild and socially acceptable form of aggression, will reduce the huge pool of repressed rage within the subconscious which may be feeding the stutter. Assertiveness, however, is not equivalent to confidence – because confidence so often implies that you are always right. Assertiveness means not being apologetic; it means being aware of your rights as a human being – having the right to speak and voice your opinion appropriately without disrespecting the rights of others. It is a win-win approach whereas aggression is win-lose. For more information on assertiveness, check out this short article in my book.

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: http://stuttersense.blogspot.co.za/2014/11/fake-it-till-you-make-it_20.html


"Visualise your success." 

Visualisation should be very useful in changing the subconscious. Visualisation is such a powerful tool in modern self-help and it always surprises me how little this is used by people who stutter. Have a look at this short chapter on visualisation in my free online book: http://copingwithstuttering.blogspot.co.za/2010/02/power-of-visualisation.html


"Do not go it alone." 

This is a well-tested principle in stuttering treatment and also holds true for the psychotherapeutic approach to stuttering. If you are serious to get the upper hand in stuttering, don't try to walk this road alone. Stuttering is in many ways a social disorder – most stuttering people don't stutter when alone – so it makes sense to enlist others in your efforts. Discussing stuttering with others who stutter is extremely therapeutic as it discharges tons of negative emotions which have accumulated over the years and that have maintained high speech-linked stress / anxiety levels. There are so many ways to do so:

 Find a "speech buddy" by means of one of the Facebook stuttering groups, and share ideas, audioclips and videos with him / her regularly via Facebook, Messenger, Google Hangouts, Skype etc.

 Join one of the Google Hangouts for people who stutter.

Join a support / self-help group in your area for people who stutter. If such a group does not exist in your area, consider creating one yourself.

Enlist as many people as possible in your efforts – family members, friends, colleagues. Discuss stuttering with them, explain it and let them know what you are doing and how they can assist.



Stuttering children 

Parents should ensure that a home atmosphere is created which encourages the stuttering child to express himself / herself freely, instead of bottling up emotions such as rage or fear. If it is true that repressed negative emotions lead to stuttering, it makes sense to try and "unrepress" those emotions. Keep in mind that Highly Sensitive Children (HSCs) may be prone to stuttering because of their sensitive nature, and that research has found that most stuttering children ARE in fact HSCs. 

Example: An older twin sister, who is her younger brother's best friend, tends to always get the first word in, thereby frustrating the brother. But being sensitive he doesn't want to upset their friendship and doesn't express his irritation, instead repressing it. Eventually, however, his irritation turns to anger / rage, which is also repressed. In due course this repressed anger / rage accumulates and may cause mindbody symptoms such as stuttering.  


C. Speaking technique

Develop the correct mindset before starting a conversation. Before speaking, ask yourself the "golden question": "Right now, what emotion am I feeling?" If it is fear, rage, embarrassment etc., fully accept and acknowledge that feeling, instead of fighting it. Fighting it means repressing it, which is the wrong way to handle it. Yes, it's not easy, and fear may make you tremble, sweat etc. But the emotion will go away, while you will still be there. Try to "ride out" the emotion and, if necessary, use a fluency technique like "passive airflow", "slow / prolonged speech", "slowed first syllable / slow start / easy onset" etc. to get you speaking.

This procedure, namely getting in touch with your emotions before and during speaking, should eventually become easier as it becomes a habit. Identifying and acknowledging the feeling before and during speaking sends an extremely powerful signal to the subconscious defense mechanism that it no longer needs to send symptoms, because you have acknowledged the repressed emotion.

When you do stutter, shift your attention to a possible psychological cause, like something you are worried about, a chronic family or financial problem, a recurrent source of irritation etc., for that sends a message to the brain that you're no longer deceived by the stutter, says Dr Sarno. When that message reaches the depths of the mind, the subconscious, the stutter is weakened.


D. The Daily Reminders


Take ten minutes off every day and read the following Daily Reminders slowly, taking time to consider them so that they sink deeply into your subconscious. Even better, MEMORIZE them:



E. If you're not making progress, or are having relapses or new mindbody symptoms

·        Have a look at this diagram:





It may be that mindbody tools such as assertiveness, feeling the emotions etc. are not sufficient to totally prevent the vocal-cord lockdown (the "blocks") which lies at the core of all stuttering behaviour. Though mindbody principles should reduce the amount of tension flowing from your subconscious, some tension may still get through. If that is the case, supplement these mindbody tools with symptomatic aids such as 1) Stress Management 2) Fluency techniques such as the Passive Airflow Technique (note that I made a number of Youtube videos on this technique, and so has Dr Martin F Schwartz. I also wrote a book on this technique. Visit my Stuttersense website for more information.) In this way you will be addressing the stutter at all levels.

Some people experience immediate fluency improvement after starting this programme. For others it may be some weeks or months before there is a change. Keep in mind that adults who stutter have been doing so for years or decades, so DO NOT expect a quick miracle cure! Don't be impatient - psychological healing can take time and effort.

A great deal of stuttering – the actual word / sound repetitions, struggle behaviours etc., but not the vocal-cord locking –  has been conditioned (learned). In other words, it has become a habit. All kinds of things may trigger stuttering, such as a particular situation, person or type of person, particular sounds or words etc. But … this can be unlearned. Check out the book Unlearn Your Pain, by Dr Howard Schubiner MD, for more information (it's about chronic pain, but is also applicable to stuttering).·   

Re-read one of the TMS books. It may be that subconsciously you do not entirely believe the TMS explanation. The subconscious will only stop sending symptoms if it is convinced that its deception has been discovered. So allow these books, and the ideas in them, to sink in deeply into your subconscious.

For many people this is a "two steps forward, one step backward" process. Again, note that adults who have stuttered for decades can't expect a quick miracle cure. The muscles of the vocal cords are fine structures that are easily overwhelmed by the tensions engendered by the central nervous system. And … subconscious change takes time. Also, relapses may occur as the mind tries to return to the old state of affairs. There probably will be setbacks, and the devious subconscious may try to convince you that your case is hopeless … don't be deceived! The subconscious mind is full of tricks. Just continue with your focus on exposing those repressed emotions. Don't let these relapses discourage you – actually they are a sign of progress! They demonstrate that the subconscious mind has taken note of your fluency improvement, and is trying desperately to regain the territory it has lost.

The subconscious defense mechanism, in its efforts to maintain its power, may create NEW mindbody symptoms to replace the stutter. Dr Sarno calls them "symptoms imperative". Examples are skin rashes (that's what I'm getting lol), unexplained muscle pains, stomach upsets etc. Their purpose is to again distract your attention away from your current focus on your repressed emotions, toward your body – in the same way that stuttering distracts you away from the mind. "Symptoms imperative", too, are actually signs that you are making progress! You've got the TMS on the run, and it is desperately trying to find a new seat from which it can cause mischief. Continue to "think psychologically" about your stuttering – but if your replacement symptoms are severe, rather take a step back and halt your fluency efforts until your subconscious mind has adjusted to the progress made.

Do LOTS of relaxation exercises and stress management. The TMS self-therapy, which you are busy with, is aimed at changing the subconscious, and subconscious change can be really stressful. Read this chapter of my book on how to deal with change.

If you feel that it is all overwhelming and getting too much, or if you are getting panic attacks and feel anxious, simply stop it all and take a step backward – watch a movie, do something relaxing, forget about TMS and healing. The periods of anxiety should be temporary. When you feel more at ease, you can return to journalling or whatever you do to reduce TMS symptoms.

If you are making no progress at all even after months of working on this, you may want some external support from a TMS practitioner. About one out of five TMS patients may need this extra attention. Many of these TMS practitioners work via Skype or Google Hangouts, so not having one of them in your area is not an obstacle. Look out for them on the internet.

On Youtube and elsewhere on the web you will find lots of great videos and treatment programmes for TMS. Check out all the videos by or featuring Dr John Sarno MD and / or Dr Howard Schubiner MD and / or Dr David Schechter MD or any other TMS practitioner. They are usually about chronic pain, but simply treat them as if they address chronic stuttering. Eg. have a look at the excellent FREE videos on this site.


WISHING YOU WELL!

10 comments:

  1. Thanks Peter for this great knowledgeable blog, you just compiled all in one really. .
    Peter, when we divert our attention from physical symbols (stuttering) to emotions ( embarrassment, fear, anger, shame etc) and figuring out these emotions, while speaking what to do with this emotions so this emotions can't bother us to speaking easily??? because even i feels such emotions i still stutter, i hope you get my point . .

    Regards,
    Abdul Haseeb
    KSA

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  2. A great point, Abdul ... My impression is that feeling the emotions does help; but even so those conscious feelings are also arousing (stressful) and can result in tensioning of our vocal cords and stuttering. That's why I believe that this approach should be accompanied by a fluency technique that will "catch" any arousal created by the conscious feelings. I don't see this focus on emotions as a wonder cure; it's just one more tool in our toolbox to tackle stuttering. Keep in mind that it's not just the repressed emotions that are the source of stuttering. Other sources are day-to-day stresses, not feeling well etc. The bottom line is that body and mind are intimately connected, and that negative emotions, both unconscious and conscious, could translate into tension that affects our vocal cords, resulting in stuttering.

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    1. So can we tackle these negative emotions and turn into positive emotions by self talks/talk to our brain and affirmation??
      For instance i've to talk in a social circle and before speaking i'm feeling negative emotions so on that time what i supposed to do ?? use just let it be and let it go strategy or talk to my brain with affirmations??
      Because what i believe is that we couldn't use our technique until we're mentally relax, positive and confident enough.

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    2. Acknowledging negative feelings does not exclude other approaches. Much will depend on one's mindset BEFORE speaking. Personally I try to have a pre-speech mindset where I acknowledge any negative feelings; then, when I speak, I also use the Passive Airflow as much as possible: slowed first syllables, slight passive air from the mouth before difficult words, relaxing body and mind. These are physical interventions and they do help even if I feel stressed; I can force myself to speak slower even when stressed or not feeling confident. Self-talk and affirmations are great, but they should perhaps be done during the day as exercises. At the time when I worked hard on my speech, I did affirmations as part of a Progressive Muscle Relaxation procedure in a hot bath or in bed. Self-talk should be done throughout the day. I am not sure if it is a good idea to turn negative emotions into positive emotions, that seems to be a type of repressing or suppressing of the negatives. Positive emotions need to be natural and should have a reason, otherwise they will be false. If you feel worried and say to yourself that you're not worried, that's inauthentic, that's not being truthful with yourself. But it also depends on what exactly you're saying to yourself. If you say to yourself that others don't really care so much about how you speak, that's a worthwhile positive idea, but it's not an emotion.

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    3. Abdul, one more thing: Keep in mind that, though we THINK that we are in touch with our emotions, there may be other unaware emotions lurking within the unconscious which sabotage our attempts. Compare this with the analogy of the iceberg: what we see or feel is just a tip of the unseen iceberg beneath the surface. For instance, we may think that we have identified "fear" and/or "shame", but we may have missed "anger / rage". These feelings often come in collections of many emotions. Then also, if a strategy does not work, try another. For instance, if the identifying of hidden emotions is problematic, try the principle of expressiveness. That is the opposite of repressiveness and seems to work in many cases. In other words, speak with authority, assertiveness and boldness. "Do not hold back" seems to neutralise our TMS-based instinct to hold back, to repress, to be over-sensitive, perfectionistic, introverted and inhibited.

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    4. Peter, what you mean to say is that don't try to control, repress or neglect but respect, emphasis, acknowledge and stimulate these emotions and let these emotions go spontaneously, isn't??
      so what about expressiveness by telling openly about your stuttering to others but it's not easy for everyone; and yes indeed to be assertive and avoid hold back is an important aspect of fluency but it's also depend upon how much your command having on your technique.

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    5. Meanwhile, i'm little confuse related to talk to your brain and inner child subjects, and i'm taking these subjects as to not allowing these emotions to superimpose on you and making you more uncomfortable so give positive signals to your brain by affirmations and self talk

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    6. Abdul, yes I agree, being open with others about stuttering is important. That is always a good thing. It will tremendously reduce stress and the pressure on you to be fluent; by explaining that you stutter you will get rid of lots of emotional baggage which maintained the stutter. So the more you talk to others about it, the better; but don't allow this to become an obsession, because stuttering is, so I believe, only a symptom. And yes, knowing how to use a fluency technique also helps a lot, but that comes with practice. There are many types of techniques - use one that you like and that seems to help you.... Talking to your brain and your inner child is a continuing process; the more you do it the easier it will become. Even just being aware of the inner child is already a step in the right direction; these inner talks one should do for the rest of one's life, as it is a part of maintaining good mental health, which is just as important as physical health. Self-talk also helps to get rid of unnecessary emotions such as guilt and shame. As mentioned before, such emotions are understandable because when we were young, we maybe received the message that stuttering is "bad"; or people may have laughed at us so that we received the message that stuttering is funny - and this damaged our self-concept. This is why we began to develop feelings of shame and guilt. But now we know that such feelings are unnecessary, as there is no reason to feel shame or guilty, because stuttering is a disorder and not a moral or ethical failure. So in due course such feelings should diminish. Other emotions though such as rage / anger are a different matter, and they should definitely not be repressed but released in appropriate ways - of course, not by shouting at people or fighting, or directing the rage to ourselves, but in more constructive ways.

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  3. Excellent information to say the least as always Peter!!!

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    1. Many thanks, Brian! Your support is very encouraging!

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