Introduction

Stuttering affects both the speaker and the listener. But both the parties do not acknowledge it under some kind of unsaid convention or arrangement. Yet, there is significant frustration on both sides. On the
speaker's part, because he feels that he has failed one of the most basic requirements of social transaction. On the listener's side - because they have no precedent or understanding to make sense of what just transpired;  nor did they feel free to ask questions. Stammering has often been compared to a hippo sitting between two conversationalists on a coffee table: entirely unwelcome and unacknowledged- but very much there (see the cartoon below).

About 3-1 people out of every 100 adults stammer in any population. The incidence is higher than that of HIV+ people in India. Yet we know more about AIDS than about stuttering. Most of us stutterers and
non-stutterers, have erroneously believed that the problem will go away if we do not acknowledge it, if we do not talk about it. It does usually- by going underground- and always returns with a greater force.

Few SLPs specialize in stammering- so called fluency disorders. Even these few are forced to migrate elsewhere for lack of enough work and recognition in India. Why don’t PWS come forward for therapy? Even when it is offered for free? They have explored every bit of their mind and mouth, speech and various strategies but have failed to answer the basic question: why do I stammer sometimes? Not all the time? How can I help myself?

Since we are dysfluent some times and fluent rest of the time, we intuitively realize that the problem and solution both lies in our own mouth. And yet nothing seems to work consistently. The result is: we
give up hope and become skeptical. Haven't we tried everything? What can a SLP tell us new? Either we withdraw in a receding shell of denial or go about life with fatalistic acceptance of our speech and associated issues.

Today most PWS seeking professional help are young. They are at a stage in life when developing associations, building relationships and excelling at academics and career is of great importance. All this
requires communication skills. Hence most such young clients are desperate for a fast "cure" as they understand it. Even when SLPs are able to convince them for the need to work on a long term therapy goal of managing their stutter rather than eradicating it, few persist with the therapy and relapse of old ways of talking is frequent. The reason is: few PWS are able to keep their motivational level high once they are out of the therapy program and secondly, there are no self help groups, where they could practice their new skills and get ongoing support.

The Indian Stammering Association (TISA) tries to fulfill these needs through this self help book. Use it as a manual and start a self help group in your neighborhood, workplace or on the web. Stuttering is one
health condition, where your well-being is truly connected with that of the others. It has been termed a disorder of social presentation of oneself (-we don't stammer when we are alone and talk to ourselves-);
Hence the "cure" too has to be found in social settings. One last word, this book will absolutely do nothing for you if you do not practice the concepts described here in! Instead of reading it as an informative book, work with it like a 'Do it yourself manual' over a period of 1-2 years or even longer.

The Manual

This manual is primarily meant for PWS, especially covert stutterers and those who suffer from so called "mild" stuttering; Those with a greater degree of stuttering or related problems, should consider other
approaches: consulting a SLP, joining a self help group, talking to an older PWS etc. Finally those PWS who cannot do any of these, even they may learn some helpful ideas from this manual.

Equipments: These equipments will be needed for some of the exercises. A simple tape-recorder; a video camera (even the cell-phones with a video camera will do), a diary to keep notes (you could even blog if you are a `Leo' and courageous!), a mirror. Finally, having a sympathetic friend or a support group can help tremendously- by offering us objective feedback and other support, as we go along on this path of
self-discovery and self-mastery.

Know thy stammer

Know thy stammer and thy stammer shall set you free.

This might seem stretching an old adage a little bit too far- but nothing could be truer than this. We live in a bubble of denial where we do not know our stutter and the related behaviors, feelings and attitudes at all. All we know is the uncomfortable response we get occasionally from our audience. Uncomfortable response?  To what? To our speech, that is about all we know. But what did we do with our speech mechanism, our breathing muscles, facial muscles, our eyes, our limbs, posture – in that passing (-our judgment of time also is impaired-) moment of great difficulty- this we do not know. Some PWS compare that moment to the confusion and desperation of someone suddenly drowning. How did we psychologically react to that moment of difficulty? Did we give up the forward movement of speech in our confusion and distress? Did we exaggerate the movements of our hand or head to get the word out? Did we feel irritated by the listener and hold them 'responsible' for our difficulties? What exactly transpired through our body and mind in those moments- this we do not know? All that we are aware of is- vague
ache and tension in the throat, chest, face and a sense of failure, embarrassment and helplessness.

We have learned from our childhood to despise and shun our stammering. But since it does happen in spite of this, our conscious mind plays a trick and 'erases' these uncomfortable moments from the 'tape' of our day to day memory. The conscious mind denies the problem and takes no cognizance of the events. It is relegated to the realm of 'unconscious' behavior or reactions. Many PWS believe that it is not they who do their stuttering: it just happens by itself! And hence, how can they do anything about it? So, there is no cure for it.

In this first step, we will learn how to regain control of the 'lost kingdom' and discover that it is we who stutter and not our mouth which does it on its own. To do this, we record, review, study and analyze our
speech in following steps. A word of caution, this is the most difficult and painful step, but if you can do it, three quarters of the battle is won:

Step 1

Record your speech under different circumstances: reading a newspaper or a book; talking to yourself or children, talking with a friend or in a small group. Start with the most comfortable situation, like reading
alone. Use a simple audio tape or a cell-phone with camera, whatever convenient. Latter will have the advantage of recording both your speech as well as your facial expressions. First few minutes, you might be too conscious of the recording but later you will get used to it and speak in your normal style. So let the recording be long enough, 5-6 minutes or more. In your diary, record the date, time and situation (reading alone, on phone, discussing in group etc) under which you recorded. If you are using the phone camera, you may use a friend. If this friend is a PWS, all the better. Essentially it can be anyone you trust.

Step 2

Replay the tape- listen to your speech, study your body language, facial expressions, hands etc. if it is a video recording; review these even in those moments when you are speaking fluently. Compare this, with those moments when you are having a little hesitation or difficulty. As a listener now, try to guess how you are coming through as a speaker.

Confident? Comfortable with yourself and the subject? Enjoying every moment of it? Or in a hurry to finish? Based on what you see and hear, try to guess, your emotional and psychological states as you were
speaking those words on the tape. Replay the moments when you think you were not very comfortable. Pause the tape frequently to see and hear: did your pitch go up as you came across a 'difficult' word? Was there a struggle to push out a difficult sound? Did your lip press together with greater force and for longer duration than you would normally expect?

Record your observations in the diary, against the entries you made in step one above.

Step 3

Review these recordings over a long period- 3-6 months and try to note down, what do you do differently, in the moments of difficulty as opposed to when you are speaking fluently. It will be even more useful,
if you could review these tapes with a trusted friend or a recovering stutterer. You could go a step further and fake your stutter while alone- and stay in that moment for couple of minutes- to know what it
actually feels like, in mouth, in body and mind. In other words- consciously reproduce a moment of your stuttering and hold it there: My name is s-------------achin. I live in K-k-k-k.....Kanpur. Etc.

If you could do it in a normal conversation with pet, children and friends (in this order), you would even discover unique emotions associated with your stuttering, but completely unknown to you till then; buried deep in your being. So, later on, when you start to deal with your stutter, you address not only what your mouth does, but also what your mind, your emotions do in those moments of difficulties.

Step 4

Meet other PWS, read their posts on chat groups, their biographies on web. While reading, try to compare your life with theirs; your observations with theirs; your problem-solving approaches with theirs. This will help you to understand that:

1. Your experiences as PWS are not unique and

2. Your responses to your problems are also not unique.

You can learn from their experiments. Knowing your 'speech' is not enough; you must know yourself as a total human being: your attitude towards life, relationships, responsibilities, career, recreation, creativity and how these have been influenced by your speech; your deepest fears and aspirations. One way is to meet others on the same path and compare notes and the second complimentary path is diving within yourself: sitting quiet and reviewing your life, contemplation, meditation. Vipassana meditation has helped some people in this regard.

Read more about it later in this manual.

Step 1-3 should be repeated as often as you want, with your review and analysis becoming deeper and deeper. Finally, a time should come when you know your stammer so well that you can reproduce it 100% at will in a mimicry contest among friends! This signifies complete emotional healing- an important stage. But there is more to be done, so that your audience is able to understand what you are saying. You still have to become a good communicator.

Working on your speech

Many years ago, a rabid dog charged at us. I slipped in to the car, closed the door and peeped out of the window! Another colleague of mine went out, took a stout stick and as the dog approached the car, he
dropped it dead with one well placed blow to its head. Both approaches are fine. There is another approach: we could stay out, paralyzed with fear and be bitten. This last approach, many PWS have tried and found unsatisfactory.

The first approach is like Fluency shaping techniques. You build up on your inherent fluency, you stop interfering with these actually. Your desire to be fluent does the rest.

The second approach, stuttering modification, is a better one in my opinion because it teaches you to conquer your fear- not only of stammering- but of everything else on earth. Instead of running away
from a pack of monkeys, you steadily walk towards them, and they move away.

Stuttering modification

Self exposure

For many of us, denial becomes so ingrained that not even in dreams, we will not accept our speech difficulties. So here we begin from simple to difficult tasks, in following suggested order:

1. While in shower (or anywhere private) whisper or say to yourself for some days - I stammer. Yes, I stammer. And this is fine...

2. When you are comfortable with the above, say that or something similar to your pet (dog, cat, bird, lizard, Mamba!) or a child - You know, sometime, I feel totally stuck; can’t say my own name.

3. Now say the same thing, after some days, to your nearest relative or friend (wife, mother, friend- but not to boss yet!)- You know, sometime, I feel totally stuck; can’t say the simplest thing. If they ask a question, answer that briefly, objectively without excitement.

4. After you are comfortable with above steps, try doing the same with a colleague, a chance acquaintance, someone sitting next to you in a bus. Make sure that you sound casual and that the occasion is appropriate, that the other person is not in a big rush.

5. Next, after some months of constant practice, when you have to give an informal presentation or group talk, start casually with something like this:
You give me just two minutes. Unfair, because with my tongue (or my stammer) I am sure I am going to take four minutes. How many of you are willing to give me four minutes? Raise your hands...
And then begin full steam ahead.

Experiment with this and other ice breakers and `humorous' intro lines for PWS listed on Judy Kuster's home page.

6. Rewards: This self exposure can take other forms too- a blog, messages to chat groups, letter to editors of local dailies, a poem or a story etc. When you have done this enough, there will be complete acceptance
in your heart and mind for your `stuttering self'. Then, when you open your mouth to speak, there will be no more `role conflict' and your speech will be quiet smooth.

Bouncing

Bouncing is a technique which gives us back the control over our speech mechanism and related emotions. It also teaches us to stutter in a relaxed way- as very young children do. This is the purpose of the self-therapy here: to teach us to stammer as a four year old child does. That effortless stammering is less tiring to us and less distracting to the listener as well. Lastly, it is a nice way of self exposure- Telling
people that we stammer and getting used to their reactions.

Here are the main rules:

1.       Start with easy, simple words. Bounce on difficult words only after 2-3 months of regular practice. By difficult words we mean sounds which pose problems regularly- for example for some of us, it could be K (as in Kanpur); for others it could be B (Bimal), P (Peepul) etc.

2.       Practice alone for few days; When comfortable, do it with a friend or in the self help group.

3.       Read a story book or news paper and bounce on every second or third word in every sentence. Aaj m- m-m- m- m- m- maine phal kh- kh- kh- kh- kh- kh- khaya. You just repeat the first sound (syllable) slowly. SLOWLY is the key principle here.

4.       Avoid bouncing rapidly, which happens sometimes during uncontrolled stammering:
Aaj mmmmaine phal kkkkkhaya.

This is bad bouncing. This can be avoided by stopping completely and being totally relaxed between two bounces.

5.       Vary the number of bounces. Start from 6 or more bounces and then gradually reduce it to 2-3. Then, again increase it to 5-6 or even more.

6.       Finally after some months' practice, you should be able to say a word with just one small relaxed unnoticeable bounce: Aaj mmaine phal kkhaya.

7.       If you watch TV carefully, you will notice many speakers, anchors using this little (sometime even bigger ) bounce frequently.

8.      While learning to bounce, pay close attention to your emotions. Bounce as a child does. No fear, no struggle and with total acceptance.

9.       Now, is the time to start tackling difficult words in the same way and in the same order. Start with a close friend and then, try in a bus: Give me a ticket for Ha- Ha- Herbertpur.

10.   Gradually, try to bounce on a difficult word in a spontaneous conversation on phone or in person.

11.    Whenever you fail to bounce properly on a word go back couple of steps and start again. Bounce on that very word, alone, then with a friend and then with strangers.

Voluntary stuttering

Voluntary stuttering involves- not bouncing- but actually reproducing your natural normal stutter at will. At will is the key word here. When you stutter, you have no control over it; And that is what is disturbing
and painful. Now you have to study your stammer - which you have already done, and reproduce it in all its detail and perfection. Don’t exaggerate it, don’t make it humorous or funny. Just mimic it.

Again start from - doing it alone, then with a trusted friend, then in your self help group and then finally with someone in street.
But why are we doing it? To get rid of the deep seated fear and shame and also to become conscious of all the things which we do, and which interfere with communication, our natural fluency.

If you can mimic your stutter perfectly, you can conquer it!

A good exercise is to read a book or a news paper and stutter voluntarily on a word in each sentence and then immediately repeat that word with a relaxed bounce. This will teach our nervous system the big
difference between `hard blocking' and a gentle bounce.

While trying voluntary stuttering, try to relive everything associated with your stutter: the emotions of fear and shame, tightness in throat and chest, closing of throat, lowering of gaze, jerking of hands or head
etc. Remember, all this has to be done at will and stopped at will.

This mile stone signifies your conquering of fear of stammer. Many PWS live in chronic fear: what will I do if I get totally stuck on a word or my own name in a formal meeting- and just can’t get out of that block?

If you have come thus far, you exactly know what you will be doing in such a situation and so you can go back to sleep or whatever creative projects you are doing in your life!

Secondary Behaviors

Stuttering is not just fractured speech. There are secondary behaviors, which we have picked up over our growing years, in search of some relief. All these secondary behaviors have helped initially but now have
turned into useless junk mannerisms. In fact, they interfere with efficient communication. And still we indulge in them. Why?

This is because most of us are not aware of these secondaries: raising of an eyebrow, blinking of eyes, tilting of head back; pitch rising as we approach feared word, flaring of nostrils, tightening of chest and
holding the breath, fiddling with hands etc.

Here are the steps to deal with these:

1. First we must become aware of these. As in earlier steps, study them with the help of a video camera, mirror and or a trusted friend.

2. Develop a complete list of all such unconscious reactions to difficulties faced during verbal communication.

3. Study these behaviors under different circumstances, talking to different people, discussing various things (telling a joke, reading a formal report, role playing, during a verbal confrontation, when very
angry or excited etc).

4. Now get down to changing these secondaries: Let us take the example of eye blinking. In front of a mirror or a video camera, change (and review) the rate and type of blinking through a wide range of settings.

For example, blink very fast while talking; then slowly. Then, shut your eyes completely and say a complete sentence. Then, time your slow blinking with every pause in a sentence (comma, semi-colon etc). Then, stare without blinking and say a complete sentence or two. Then, do the full exercise with another person.

5. Gradually, this will help you to develop better awareness and control over eye blinking and you will find that now, when you talk, you are able to control or stop this particular secondary behavior. Similar
exploration and experimentation should be done with every secondary behavior. Initially take them up alone and then try various combinations- eye blinking with hand movement; trembling of lips with
head jerk etc.

Points to Ponder

Almost all the steps above require lot of courage, a sense of adventure, a spirit of inquiry and a determination to face the truth, however painful it may be. Almost always the first step is the most difficult one. Once you begin, it becomes easier. The old fears do return once in a while, but shooing them away becomes easier and easier.

Now the problem is- no one can thrust this journey on us. A point comes in our life, when we feel that we have suffered enough, in silence and alone; We become aware that this kind of suffering is meaningless; It
neither turns us into a martyr nor does it lighten anybody else's burden. We discover that our old way of dealing with our stammer is totally non-productive, non-creative. It offers only one plus point: it is familiar and feels more secure therefore.

When we reach this turning point in our life, we are ready for a big quantum leap. This manual tells you how to land on both your feet safely - but leap, YOU must. (more coming).